In hospital mortality and short-term outcome of acute ischemic stroke patients contracting SARS CoV-2 infection: Experience from a dedicated stroke unit in Bangladesh

Abstract

Background and aims: In this study we intended to evaluate the influence of COVID-19 on in hospital mortality and short-term outcome of acute ischemic stroke. Methods: This was a hospital-based case-control study from February to May 2021 conducted in stroke unit of National Institute of Neurosciences and Hospital. Fifty consecutive ischemic stroke patients contracting COVID-19 infection was considered as cases (group-B) and 99 similar patients, negative for SARS CoV-2 on RT-PCR from nasal swab were considered for control group (group-A) following the inclusion and exclusion criteria. Results: Diabetes and Multiple comorbid conditions and lymphopenia were significantly (p < 0.001) more common in Group B (1% vs. 22%, 28.3% vs. 56% and 5.1% vs. 54%) in contrast to Hypertension and lymphocytosis which was more frequent in Group A (42.4% vs. 10% and 94.9% vs. 46%). The patients in group B had a significantly (p < 0.001) higher NIHSS score at admission (median IQR 7 vs. 13) and longer hospital stay (median IQR 6 days vs. 14 days). There was no significant difference among the groups in mRS at discharge (median IQR 3) and at 30 days with a median IQR of 2. Male stroke patients are 4.7 times more likely to die in-hospital. The risk of mortality is 5 times higher among COVID positive stroke cases. Conclusions: Diabetes, Multiple comorbid conditions and lymphopenia are common association in COVID positive stroke cases. The risk of mortality in 5 times higher in COVID positive stroke cases and 4.7 times among the male.