Characteristics and Outcomes of COVID-19 Related Stroke: A Cohort Study
Authors: Kasra Afsahi, Maryam Soheilifar
Abstract:
Cerebrovascular accident (CVA) is a neurological side effect of COVID-19 disease wit high rate in pandemics. Effect of COVID-19 disease on disorder is unclear. In this cohort, patients with COVID-19 disease were assessed. 60 CVA cases were assessed in a referral hospital in 2020. The major factor was mortality and the cases were those with and without death. The groups were compared for all features about mortality in the patients with COVID-19 and CVA. Totally 23 out of 60 cases (38.3%) were expired. In univariate analysis there was significant association for death by ischemic heart disease (P = 0.015), high-severity stroke (P = 0.012), high C-reactive protein (CRP) (P = 0.001), high ESR (P = 0.009), pleural effusion (P = 0.005), pericardial effusion (P = 0.027), cardiomegaly (P = 0.005), ground glass opacity (P = 0.001), and consolidation (P = 0.001). Among these factors, there was significant association only for CRP (P = 0.001) and consolidation (P = 0.003) in multivariate analysis. Mortality in the cases with COVID-19-related CVA is one-third and it has relationship to elevated CRP and finding the consolidation in the computerized tomography scan of the lungs.
Keywords: COVID-19, stroke, prognosis, C-reactive protein, CRP.
Procedia APA BibTeX Chicago EndNote Harvard JSON MLA RIS XML ISO 690 PDF Downloads 356References:
[1] Phan L, Chen-Li D, Iacobucci M, Ho R, Majeed A, McIntyre RS. Impact of COVID-19 pandemic on mental health in the general population: A systematic review. J Affect Disord. 2020; 277:55-64.
[2] Mahalmani VM, Mahendru D, Semwal A, Kaur S, Kaur H, Sarma P, et al. COVID-19 pandemic: A review based on current evidence. Indian J Pharmacol. 2020; 52(2):117-29.
[3] Zaim S, Chong JH, Sankaranarayanan V, Harky A. COVID-19 and Multiorgan Response. Curr Probl Cardiol. 2020; 45(8):100618.
[4] Mokhtari T, Hassani F, Ghaffari N, Ebrahimi B, Yarahmadi A, Hassanzadeh G. COVID-19 and multiorgan failure: A narrative review on potential mechanisms. J Mol Histol. 2020; 51(6):613-28.
[5] Wu T, Zuo Z, Kang S, Jiang L, Luo X, Xia Z, et al. Multi-organ Dysfunction in Patients with COVID-19: A Systematic Review and Meta-analysis. Aging Dis. 2020; 11(4):874-894.
[6] Baig AM, Khaleeq A, Ali U, Syeda H. Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host-Virus Interaction, and Proposed Neurotropic Mechanisms. ACS Chem Neurosci. 2020; 11(7):995-8.
[7] Renu K, Prasanna PL, Valsala Gopalakrishnan A. Coronaviruses pathogenesis, comorbidities and multi-organ damage - A review. Life Sci. 2020; 255:117839.
[8] Lukiw WJ, Pogue A, Hill JM. SARS-CoV-2 Infectivity and Neurological Targets in the Brain. Cell Mol Neurobiol. 2020; 25:1–8.
[9] Soltani Zangbar H, Gorji A, Ghadiri T. A Review on the Neurological Manifestations of COVID-19 Infection: A Mechanistic View. Mol Neurobiol. 2021; 58(2):536-49.
[10] Solomon T. Neurological infection with SARS-CoV-2 - the story so far. Nat Rev Neurol. 2021; 17(2):65-6.
[11] Wang L, Ren Z, Ma L, Han Y, Wei W, Jiang E, et al. Progress in Research on SARS-CoV-2 Infection Causing Neurological Diseases and Its Infection Mechanism. Front Neurol. 2021; 11:592888.
[12] Reza-Zaldívar EE, Hernández-Sapiéns MA, Minjarez B, Gómez-Pinedo U, Márquez-Aguirre AL, Mateos-Díaz JC, et al. Infection Mechanism of SARS-COV-2 and Its Implication on the Nervous System. Front Immunol. 2021 Jan 29; 11:621735.
[13] Correia AO, Feitosa PWG, Moreira JLS, Nogueira SÁR, Fonseca RB, Nobre MEP. Neurological manifestations of COVID-19 and other coronaviruses: A systematic review. Neurol Psychiatry Brain Res. 2020; 37:27-32.
[14] Requena M, Olivé-Gadea M, Muchada M, García-Tornel Á, Deck M, Juega J, et al. COVID-19 and Stroke: Incidence and Etiological Description in a High-Volume Center. J Stroke Cerebrovasc Dis. 2020; 29(11):105225.
[15] Ntaios G, Michel P, Georgiopoulos G, Guo Y, Li W, Xiong J, et al. Characteristics and Outcomes in Patients With COVID-19 and Acute Ischemic Stroke: The Global COVID-19 Stroke Registry. Stroke. 2020; 51(9):254-8.
[16] Mehrpour M, Shuaib A, Farahani M, Hatamabadi HR, Fatehi Z, Ghaffari M, et al. Coronavirus disease 2019 and stroke in Iran: a case series and effects on stroke admissions. Int J Stroke. 2020:1747493020937397.
[17] Nannoni S, de Groot R, Bell S, Markus HS. Stroke in COVID-19: A systematic review and meta-analysis. Int J Stroke. 2021; 16(2):137-49.
[18] Yamakawa M, Kuno T, Mikami T, Takagi H, Gronseth G. Clinical Characteristics of Stroke with COVID-19: A Systematic Review and Meta-Analysis. J Stroke Cerebrovasc Dis. 2020; 29(12):105288.
[19] Diener HC, Berlit P, Masjuan J. COVID-19: patients with stroke or risk of stroke. Eur Heart J Suppl. 2020; 22(Suppl Pt t):25-8.
[20] Trejo-Gabriel-Galán JM. Stroke as a complication and prognostic factor of COVID-19. Neurologia. 2020; 35(5):318-22.
[21] Siniscalchi A, Gallelli L. Could COVID-19 represent a negative prognostic factor in patients with stroke? Infect Control Hosp Epidemiol. 2020; 41(9):1115-6.
[22] Benny R, Singh RK, Venkitachalam A, Lalla RS, Pandit RA, Panchal KC, et al. Characteristics and outcomes of 100 consecutive patients with acute stroke and COVID-19. J Neurol Sci. 2021; 423:117348.
[23] Izcovich A, Ragusa MA, Tortosa F, Lavena Marzio MA, Agnoletti C, Bengolea A, et al. Prognostic factors for severity and mortality in patients infected with COVID-19: A systematic review. PLoS One. 2020; 15(11):e0241955.