Characteristics of ischemic stroke in patients with confirmed coronavirus disease 2019 infection in Vojvodina, Serbia

Abstract

Introduction. The World Health Organization declared a pandemic of coronavirus disease 2019 on March 11, 2020. The literature has shown that coronavirus disease 2019 is associated with thromboembolic complications, including ischemic stroke. This retrospective study aims to present the characteristics of ischemic stroke in patients with coronavirus disease 2019. Material and Methods. This retrospective study was conducted in the period from April 2020 to January 2022 at the Clinical Center of Vojvodina, and included 58 patients with confirmed coronavirus disease 2019 and a new-onset ischemic stroke. Results. The reason for hospitalization in 42 (72.41%) patients was a new-onset ischemic stroke and 16 of them (38.09%) had a previously confirmed coronavirus disease 2019. In 16 patients (27.58%), ischemic stroke occurred during hospital treatment due to severe clinical manifestations of coronavirus disease 2019. In most coronavirus disease 2019 positive patients the etiology of ischemic stroke was unknown. In most cases (43.1%), the ischemic stroke was a partial infarction of the anterior circulation. Nine patients (15.51%) received intravenous thrombolytic therapy (alteplase) in the appropriate time frame. Lethal outcome occurred in 21 patients, of which in 11 patients complications of coronavirus disease 2019 were the cause of death. Conclusion. A large number of cases with stroke and thrombotic complications in patients with coronavirus disease 2019 is a good indicator that severe acute respiratory syndrome coronavirus 2 does not only cause respiratory infections, but is a systemic infection. The etiology of most ischemic strokes was unknown, which is probably related to difficult functioning of the health system during the pandemic.