Clinical Characteristics of Stroke with COVID-19: A Systematic Review and Meta-Analysis

The study titled “Clinical Characteristics of Stroke with COVID-19: A Systematic Review and Meta-Analysis” provides valuable insights into the occurrence and characteristics of stroke in COVID-19 patients.

Here’s a detailed summary:

Background and Methods: This study investigates the link between COVID-19 and the increased risk of thromboembolism and stroke. Using a systematic review and meta-analysis approach, the research analyzed data from 10 retrospective cohort studies and 16 case series/reports, involving a total of 183 patients who had COVID-19 and subsequently experienced a stroke. The study aimed to determine the frequency and clinical characteristics of strokes in these patients.

Key Findings:

  1. Frequency of Stroke: The frequency of detected stroke in hospitalized COVID-19 patients was approximately 1.1%. This rate indicates a significant occurrence of stroke among those hospitalized with COVID-19.
  2. Patient Demographics: The mean age of patients who experienced stroke was 66.6 years, and about 65.6% of these patients were male. This suggests that older age and male gender might be associated with a higher risk of stroke in COVID-19 patients.
  3. Time from COVID-19 Onset to Stroke: On average, strokes occurred around 8 days from the onset of COVID-19 symptoms. This timeline is crucial for healthcare providers to monitor and manage stroke risk in COVID-19 patients.
  4. D-dimer Levels: Elevated D-dimer levels were observed, with an average of 3.3 mg/mL. High D-dimer levels are typically associated with increased risk of thromboembolism, and in the context of COVID-19, this indicates a heightened risk of stroke.
  5. Type of Stroke: Cryptogenic stroke, where the cause of the stroke is unknown, was the most common etiology, accounting for 50.7% of cases. This high percentage of cryptogenic strokes suggests a unique pathophysiology of stroke in the context of COVID-19, possibly related to the virus’s effects on the blood vessels or clotting mechanisms.
  6. Mortality Rate: The case fatality rate among these patients was notably high at 44.2%. This elevated mortality rate underscores the severity of stroke as a complication of COVID-19 and the need for prompt and effective treatment strategies.

Conclusions and Implications: The study concludes that there is a significant frequency of stroke in hospitalized COVID-19 patients, predominantly older adults with stroke risk factors. The findings of frequent cryptogenic strokes and elevated d-dimer levels point to an increased risk of thromboembolism associated with COVID-19. The high mortality rate further emphasizes the need for more research to understand the pathophysiology and prognosis of stroke in the context of COVID-19. This understanding is essential for developing effective care strategies for this patient population​​.

In summary, this study highlights the critical association between COVID-19 and increased stroke risk, particularly in older patients and those with elevated d-dimer levels. The findings call for heightened vigilance and proactive management of stroke risk in patients with COVID-19.

Read More: https://www.sciencedirect.com/science/article/pii/S1052305720307060

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