Increased Incidence of Acute Ischemic Stroke in COVID-19 Patients

Abstract

Purpose: The coronavirus disease 2019 (COVID-19) is an active epidemic that is rapidly spreading globally with various complications. Although there are publications on the frequency of thromboembolic complications with COVID-19, the number of publications showing a strong relationship with acute ischemic stroke is few. We aimed to evaluate the link between COVID-19 and acute ischemic stroke. Methods: One hundred and six patient were screened retrospectively who were underwent brain diffusion MRI with the suspicion of acute stroke in our institution between April and August 2020 when the COVID-19 pandemic intense. The data on diagnosis of COVID-19 infection were analyzed according to patient demographics and risk factors; patients are separated into two groups as with and without acute ischemic stroke findings. A univariate analysis was performed to show the relationship of risk factors and the presence of COVID-19 with acute ischemic stroke. Results: Acute stroke imaging findings were detected in 39 of 106 patients; and 67 patients without signs of acute ischemic stroke were considered as the control group. The mean age for subjects and controls was 61.8±4.8 and 61.2±4.9 years, respectively. Seventeen (43.6%) of the patients with acute ischemic stroke findings had COVID-19 infection. In the control group, 12 (17.9%) were positive for COVID-19 (p<0.05). No significant relationship was found for age, gender and other risk factors. However, COVID-19 infection had a significant independent association with acute ischemic stroke compared to control subjects (OR 3.5; 95% CI 1.4–8.6; P < 0.005). Conclusion: COVID-19 infection poses an increased risk for acute ischemic stroke, and therefore, it is necessary to be careful in terms of acute ischemic stroke in patients followed up for COVID-19, and imaging with diffusion MRI in suspected cases.