Study reveals frequency and characteristics of stroke in COVID-19 patients

A review of nearly 28,000 emergency department records shows less than 2% of patients diagnosed with COVID-19 suffered an ischemic stroke but those who did had an increased risk of requiring long-term care after hospital discharge. Those are the findings from a study conducted by researchers from the University of Missouri School of Medicine and MU Health Care.

The researchers teamed up with the MU Institute for Data Science and Informatics and the Tiger Institute for Health Innovation to review data from 54 health care facilities. They found 103 patients (1.3%) developed ischemic stroke among 8,163 patients with COVID-19. Comparatively, 199 patients (1.0%) developed stroke among 19,513 patients who didn’t have COVID-19.

“Patients with COVID-19 who developed acute ischemic stroke were older, more likely to be black and had a higher frequency of cardiovascular risk factors,” said lead researcher Adnan I. Qureshi, MD, a professor of clinical neurology at the MU School of Medicine.

The mean age of COVID-19 patients with stroke was 68.8 compared with 54.4 for those without stroke. Among those with COVID-19 and stroke, 45% were Black, 36% were white and 6% were Hispanic. They tended to have hypertension (84%), high fat content in the blood (75%) and diabetes (56%).

“We also found that COVID-19 patients with stroke had a significantly higher rate of discharge to a destination other than home compared to stroke patients without COVID-19,” Qureshi said. “Patients with COVID-19 tend to have multisystem involvement and elevated markers of inflammation, which have been shown to increase the rate of death or disability.”

Qureshi said his findings are somewhat different from earlier studies that suggested patients with COVID-19 who developed stroke were younger and without preexisting cardiovascular risk factors.

“Even if COVID-19 was a predisposing factor, the risk was mainly seen in those who were already at risk for stroke due to other cardiovascular risk factors,” Qureshi said.

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In addition to Qureshi, the study authors include fellow MU School of Medicine collaborators Camilo R. Gomez, MD, professor of clinical neurology; Brandi French, MD, associate professor of vascular and clinical neurology; Farhan Siddiq, MD, assistant professor of neurological surgery; Iryna Lobanova, MD, research specialist in the Department of Neurology; S. Hasan Naqvi, MD, associate professor of clinical medicine; William Baskett, graduate student; Wei Huang, graduate student; Daniel Shyu, medical student; Danny Myers, PhD, senior development project manager; Murugesan Raju, PhD, post-doctoral fellow; and Chi-Ren Shyu, PhD, director, MO Informatics Institute.

Their study, “Acute Ischemic Stroke and COVID-19,” was recently published in the journal Stroke. Part of the support for this study was provided by the National Institutes of Health. The authors of the study declare that they have no conflicts of interest related to this study and the content does not necessarily represent the official views of the National Institutes of Health.