COVID-19 and cerebral stroke

Abstract

To analyze mortality rates, rehabilitation potential, and features of the course of stroke in patients with COVID-19. The study included 50 patients in the acute period of stroke who were diagnosed with a new coronavirus infection during treatment. For comparison, we selected a group of 50 patients who had stroke during this period. In the study group, the virus was identified in 38 (76%) patients by polymerase chain reaction (PCR). The onset of symptoms of acute respiratory viral infection or fever was observed on average 11 days after the onset of neurological symptoms. Only in 10 (20%) patients, a PCR smear showed a positive result in the first 24 hours after the development of a stroke. In the main group, death was observed in 30% (n=15) of cases; in the comparison group - in 6% (n=3) cases. Also, in the main group of patients, a lower degree of recovery of impaired neurological functions was noted on the National Institutes of Health Stroke Scale (NIHSS). At discharge from the hospital, 33 (66%) patients had moderate and severe disabilities according to the modified Rankin scale (3-4 points). The differences were statistically significant, as in the main group there was more pronounced disability than in the control group. Lymphopenia was noted in 26 (52%) patients of the main group on admission. Increased mortality rate, decreased recovery of neurological functions and severe disabilities are observed in the group of patients with stroke who were infected by COVID-19. Lymphopenia in a patient with stroke can serve as a prognostic marker of the possible presence of COVID-19 and the degree of lung tissue damage.