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. 2021;50(4):371-374.
doi: 10.1159/000514267. Epub 2021 Mar 26.

Risk Factors, and Clinical and Etiological Characteristics of Ischemic Strokes in COVID-19-Infected Patients: A Systematic Review of Literature

Simone Vidale  1   2
Affiliations

Risk Factors, and Clinical and Etiological Characteristics of Ischemic Strokes in COVID-19-Infected Patients: A Systematic Review of Literature

Simone Vidale. Cerebrovasc Dis. 2021.

Abstract

Background and purpose: Coronavirus disease 2019 (CO-VID-19) infection is an ongoing pandemic and worldwide health emergency that has caused important changes in healthcare systems. Previous studies reported an increased risk of thromboembolic events, including stroke. This systematic review aims to describe the clinical features and etiological characteristics of ischemic stroke patients with CO-VID-19 infection.

Method: A literature search was performed in principal databases for studies and case reports containing data concerning risk factors, clinical features, and etiological characteristics of patients infected with COVID-19 and suffering from stroke. Descriptive and analytical statistics were applied.

Results: Overall, 14 articles were included for a total of 93 patients. Median age was 65 (IQR: 55-75) years with prevalence in males. Stroke occurred after a median of 6 days from COVID-19 infection diagnosis. Median National of Institute of Health Stroke Scale (NIHSS) score was 19. Cryptogenic (Cry) strokes were more frequent (51.8%), followed by cardioembolic etiology, and they occurred a long time after COVID-19 diagnosis compared with large-artery atherosclerosis strokes (ptrend: 0.03). The clinical severity of stroke was significantly associated with the severity grade of COVID-19 infection (ptrend: 0.03).

Conclusions: Ischemic strokes in COVID-19-infected patients were clinically severe, affecting younger patients mainly with Cry and cardioembolic etiologies. Further multicenter prospective registries are needed to better describe the causal association and the effect of COVID-19 infection on stroke.

Keywords: Coronavirus disease 2019; Etiology; Stroke.

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Conflict of interest statement

The author declares there is no conflict of interest to declare.

References

    1. Klok FA, Kruip MJHA, van der Meer NJM, Arbous MS, Gommers DAMPJ, Kant KM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020 Jul;191:145–7. - PMC - PubMed
    1. Mao L, Wang M, Chen S, He Q, Chang J, Hong C, et al. Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: a retrospective case series study. SSRN Electron J. 2020
    1. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, Chine: a retrospective cohort study. Lancet. 2020;395:1054–62. - PMC - PubMed
    1. Zayet S, Klopfenstein T, Kovacs R. Acute cerebral stroke with multiple infarctions and COVID-19. France: 2020. - PMC - PubMed
    1. Wang A, Mandingo GK, Yim PD, Meyers PM, Lavine SD. Stroke and mechanical thrombectomy in ptients with COVID-19: technical observations and patient characteristics. J Neurointerv Surg. 2020 Jul;12((7)):648–53. - PubMed

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