Higher stroke frequency in men with COVID-19 and high levels of comorbidity

Strokes in patients with COVID-19 were more common in older men with increased exposure to comorbidities. These results were presented during the International Stroke Conference March 17-19, 2021.

Study researchers looked at patients (N = 15,399) with COVID-19 who were hospitalized at 104 facilities and included in the American Heart Association’s COVID-19 cardiovascular registry between January and September 2020. They analyzed basic demographic and clinical characteristics associated with cases of ischemic stroke, transient ischemic attack, or other strokes.

A total of 201 (1.3%) patients had a diagnostic image-confirmed stroke in hospital. Of these patients, 54.2% had ischemic stroke, 2.0% had transient ischemic attack, and 0.6% had other strokes. While black patients accounted for 27% of the registry, the results showed that this population accounted for 38.3% of transient ischemic attacks and strokes.

Stratified after stroke, patients with ischemic stroke or transient ischemic attack, other strokes or without a stroke differed in terms of demographic characteristics of age (mean 65.7 vs. 65.0 vs. 61.2 years; P = 0.005) and gender ( Women: 33.9%) significant vs 35.9% vs 45.6%; P = 0.016) or race / ethnicity (black: 38.3% vs 27.2% vs 26.0%; P = 0.035). The rates between these groups differed in terms of hypertension (83.5% versus 60.9% versus 57.8%; P <0.0001), atrial fibrillation (23.0% versus 9.8% versus 8.8%; P <0.0001), cerebrovascular disease (21.7% vs. 27.2%) vs. 12.8%; P = 0.007) and diabetes (47.0% vs 39.1% vs 35.3%; P = 0.011).

During the hospital stay, the patients differed significantly in terms of transfer to the intensive care unit (73.0% versus 83.7% versus 29.8%; P <0.0001), mechanical ventilation (60.0% versus 63.0%) compared to 19.8%; P <0.0001) and kidney replacement (18.3)% vs 18.5% vs 4.0%; P <0.0001), seizure (5.2% vs 10.9% vs 0.7%; P <0.0001), length of hospital stay (mean 22.1 ± 22.3 vs 24.4 ± 22, 8 vs 9.8 ± 11.0 days; P <0.0001) and in-hospital mortality (35.7% vs 35.9% vs 16.1%; P <0.0001) based on ischemic stroke or a transient ischemic attack, other strokes, or without a stroke.

The study’s researchers concluded that patients with COVID-19 “with stroke were older and more likely to be men than patients without a stroke. Those with ischemic stroke and TIA had a higher prevalence of high blood pressure, diabetes, and atrial fibrillation compared to the other groups, and stroke rates varied by race. “

Disclosure: Several authors have stated that they are part of the pharmaceutical industry. For a full list of details, see the original article.


Shakil SS, Emmons-Bell S., Rutan C. et al. Stroke in patients hospitalized in the United States with COVID-19: Findings from the AHA COVID-19 Cardiovascular Registry. Presented at the International Stroke Conference. 2021. Presentation LB12

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