Stroke among patients hospitalized with COVID-19: Results from the American Heart Association COVID-19 Cardiovascular Disease Registry

StrokeShakil SS, Emmons-Bell S, Rutan C, et al. | October 28, 2021

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Among patients with laboratory-confirmed severe acute respiratory syndrome coronavirus-2 infection enrolled in the American Heart Association COVID-19 Cardiovascular Disease Registry, the prevalence and characteristics of strokes were investigated.

  • This quality improvement registry study involved 21,073 patients with COVID-19.

  • Acute ischemic stroke/TIA occurred in 160 (0.75%) patients (55.3% of all acute strokes) and other types of stroke were recorded in 129 (0.61%) patients.

  • Among nonischemic strokes, 44 (15.2%) had intracerebral hemorrhages, 33 (11.4%) had subarachnoid hemorrhages, 21 (7.3%) had epidural/subdural hemorrhages, 2 (0.7%) had cerebral venous sinus thromboses, and 24 (8.3%) had strokes not otherwise classified.

  • There appeared a higher prevalence of hypertension, diabetes, and atrial fibrillation among COVID-19 patients with acute ischemic stroke/TIA relative to those without stroke.

  • No variation in ischemic stroke risk was observed by race.

  • Contrary to the correlation between older age and death from COVID-19, the highest ischemic stroke risk was evident among middle-aged adults after adjusting for comorbidities and illness severity, indicating a potential mechanism for ischemic stroke in COVID-19 independent of age-related atherosclerotic pathways.

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