Risk of death, disability after stroke much higher for COVID-19 patients

COVID-19 patients who experience a stroke face a much greater risk of severe disability or death, according to a new study published in the Journal of Neurology, Neurosurgery & Psychiatry.

The new analysis focused on 81 hospitalized COVID-19 patients who experienced an ischemic stroke and five who experienced an intracerebral hemorrhage from March 9 to July 5, 2020. Outcomes were compared with nearly 1,200 ischemic stroke patients and nearly 200 intracerebral hemorrhage patients who showed no signs of COVID-19. All patients, including those who did not have COVID-19, were treated in one of 13 hospitals in England and Scotland.

Perhaps the team’s most eye-opening finding was that stroke patients with COVID-19 were twice as likely to leave the hospital still showing clear signs of severe disability. The percentage of strokes involving multiple large vessel occlusions (17.9% vs. 8.1%) and strokes resulting in inpatient mortality (19.8% vs. 9.6%) were also much higher among COVID-19 patients.

“Our findings suggest that in some people, COVID-19 may influence stroke risk through its effect on excessive blood clotting or inflammation, and may also influence the characteristics and outcome of the stroke, including greater severity with a higher chance of multiple large vessel blood clots,” co-author David Werring, PhD, of the Stroke Research Centre at the UCL Queen Square Institute of Neurology in London, said in a prepared statement. “Our findings support testing people for COVID-19 if they come into hospital with a stroke, and further research is needed to determine whether treatments (such as the use of early full-dose anticoagulation) should differ depending on this test result.”

In addition, the team added, COVID-related strokes appeared to be much worse for Asian patients. What, exactly, that means remains unclear at this point in time.

“Our study suggests that COVID-19 has had more impact on strokes in the Asian community than in other ethnic groups,” said lead author Richard J. Perry, PhD, also of the UCL Queen Square Institute of Neurology. “We cannot say from our data whether this is because people of Asian descent are more likely to catch COVID-19, or whether Asian patients with COVID-19 are more likely to have ischemic strokes, or both.”

The full analysis can be read here.