Abstract
Background: It is uncertain if patients with prior ischemic stroke are vulnerable to coronavirus disease 2019 (COVID-19) and its complications.Methods: We used TriNetX, a global health collaborative clinical research platform with a large global COVID-19 database. COVID-19 infection was identified with a positive lab value for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and related ribonucleic acid (RNA).Findings: A total of 604,258 patients with history of ischemic stroke were identified, of which 891 patients (study cohort) were diagnosed with COVID-19. A control cohort with 32,136 patients diagnosed with COVID-19 after January 20th 2020 without a history of ischemic stroke were identified. A comparison between study cohort and control cohort showed patients with prior history of stroke (study cohort) were older (69.5 vs 47.8; p<0.0001) and had more comorbidities contributing to worse clinical outcomes. After propensity matching for demographic variables and comorbidities, only rate of hospitalization (287 vs 231; p=0.0035) and need for critical care services (85 vs 55; p=0.0082) remained statistically significant while intubation (51 vs 43; p=0.39) and death (119 vs 115; p=0.77) showed trends towards worse outcomes but were not statistically significant. Interpretation: Patients with history of ischemic stroke tend to be significantly older with several comorbid conditions contributing to worse clinical outcomes after COVID-19, which makes them a vulnerable population.
Highlights
A novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in December 2019 and soon led to a worldwide pandemic, coronavirus disease 2019 (COVID-19) [1]
While there are many studies looking at risk factors for severe COVID-19 and its complications, ‘history of ischemic stroke’ as a risk factor contributing to the severity of COVID-19 has not been studied in a large population [6]
The purpose of this study is to explore if patients with prior ischemic stroke are a vulnerable population for worse clinical outcomes in patients with COVID-19
Summary
A novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in December 2019 and soon led to a worldwide pandemic, coronavirus disease 2019 (COVID-19) [1]. COVID-19 has been shown to cause several neurological manifestations including ischemic strokes [2,3,4]. The purpose of this study is to explore if patients with prior ischemic stroke are a vulnerable population for worse clinical outcomes in patients with COVID-19. It is uncertain if patients with prior ischemic stroke are vulnerable to coronavirus disease 2019 (COVID-19) and its complications
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