Sociodemographic Factors, Comorbidities, In-Hospital Complications, and Outcomes of Ischaemic Stroke Patients in the Context of the COVID-19 Pandemic in Lithuania: A Retrospective, Record-Based, Single-Centre Study.

Abstract

The role of COVID-19 regarding in-hospital complications and poor outcomes for patients with ischaemic stroke (IS) is still important to explore. The aim of this study was to evaluate the risk of in-hospital lethality for IS patientsrespectivelyto their comorbidities and in-hospital complications in the context of the COVID-19 pandemic. We identified 1898 acute IS patients (749 men and 1149 women)admitted to the Lithuanian University of Health Sciences Kaunas Hospital, Lithuania, from December 2020 to February 2022. The sociodemographic, clinical, and outcome features of the patients were evaluated deploying appropriate statistical tests. Hazard ratios and 95% confidence intervals were estimated by the Cox proportional hazards regression for hospital lethality. The risk of in-hospital lethality was 2.22 times higherin mensuffering from IS and chronic ischaemic heart disease (cIHD) compared to thosewith IS and isolated arterial hypertension (iAH) (p < 0.05). COVID-19 elevated the risk of in-hospital lethality in men by3.16 times (p < 0.05). In comorbid womenwith type two diabetes mellitus (DM) or cIHD, the risk of in-hospital lethality was two times higher compared to thosewith iAH (p < 0.05). The risk of in-hospital lethality increased significantly in both men and women, with the total number of in-hospital complications increasing per one unit. Of the comorbidities studied, DM and cIHD together with COVID-19elevated the risk of in-hospital lethality significantly. Within the acute in-hospital complications, pneumonia with respiratory failure and acute renal failure showed the most significant prognostic value anticipating lethal outcomes for IS patients.