Infectious Disease

Stroke is rare in large cohort studies of patients hospitalized with COVID-19

April 15, 2021

2 min read

Source / information

Source:

Fanning J, et al. Stroke that complicates critically ill patients with SARS-CoV-2: Analysis of the international multicenter observational study of the COVID-19 Critical Care Consortium (CCCC). Presented at: American Academy of Neurology Annual Meeting; 17.-22. April 2021 (virtual meeting).

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Acute stroke was rare in a cohort of nearly 2,700 “critically ill” patients with COVID-19, according to an international registry that also showed higher mortality from hemorrhagic but non-ischemic stroke.

The study results showed that 59 of the 2,699 patients with COVID-19 (2.2%) had an acute stroke during their admission to the intensive care unit. The researchers presented their results at the American Academy of Neurology’s annual meeting, which takes place virtually.

Reference: Fanning J, et al. Stroke that complicates critically ill patients with SARS-CoV-2: Analysis of the international multicenter observational study of the COVID-19 Critical Care Consortium (CCCC). Presented at: American Academy of Neurology Annual Meeting; 17.-22. April 2021 (virtual meeting).

“Stroke was a known serious complication of COVID-19. Some studies have reported an unexpectedly high incidence, particularly in young people,” said the study’s author Jonathon Fanning, BSc, MBBS, PhD, FANZCA, FCICM, from the University of Queensland in Brisbane, Australia, and a member of the American Academy of Neurology, said in a press release. “However, among the sickest patients admitted to an intensive care unit, our research found that stroke is not a common complication and that stroke caused by a blood clot does not increase the risk of death.”

Fanning and colleagues analyzed the stroke rate as a complication of COVID-19 infection that required admission to the intensive care unit, as well as the types of stroke and their associated outcomes. Specifically, they looked at the effects of stroke on ICU mortality and discharge rates. The patient data came from the COVID-19 Critical Care Consortium, a prospective observational study that enrolled patients over the age of 18 who needed admission to the intensive care unit due to COVID-19. The analysis included patients who were diagnosed with an acute stroke after admission to the intensive care unit between January 1, 2020 and December 21, 2020.

The researchers enrolled 2,699 patients in more than 370 locations in 52 countries. The study consisted mostly of men (65%) and the mean age of the patients was 53 years.

Of these patients, 59 (2.2%) had an acute stroke during their stay in the intensive care unit, including 19 patients with an ischemic stroke (32%) and 27 patients with a hemorrhagic stroke (46%). According to study results, the type of stroke was unspecified in 13 patients (22%).

A survival model showed that the likelihood of having a stroke in the intensive care unit was small, but that likelihood increased over time. Fanning and colleagues found that hemorrhagic stroke “greatly increased” the cumulative risk of death (HR = 2.7; 95% CI, 1.4-5.3), while ischemic stroke did not (HR = 1; 95%) % CI, 0.5-2.4).

The researchers observed high mortality in patients with hemorrhagic stroke (72%), but stroke was the leading cause of death in only 15% of patients. According to study results, multiple organ failure was the leading cause of death.

“For people with COVID-19 in intensive care, our large study found that stroke is not the common and infrequent cause of death,” Fanning said in the press release. “Even so, COVID-19 is a new disease and mutations have led to new variants. Therefore, it is important to further study stroke in people with this disease. More importantly, the percentage of those affected may not be as high as we initially thought. However, the severity of the pandemic means the absolute total number of patients around the world who will have a stroke, and the lingering impact this has over the years could create a major public health crisis. “

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American Academy of Neurology Annual Meeting

American Academy of Neurology Annual Meeting

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