Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun;9(12):988.
doi: 10.21037/atm-21-2237.

Clinical course and outcomes of COVID-19 patients with a history of cerebrovascular disease: a retrospective study in Wuhan

Yang Bai  1   2 , Yong Liang  1 , Fang Wang  3 , Ligang Chen  1 , Yulong Zhao  1 , Shoujie Zhao  4 , Yejing Zhu  4 , Yushu Dong  1 , Guobiao Liang  1 , Dongfeng Chen  2 , Lei Liu  2   5
Affiliations

Clinical course and outcomes of COVID-19 patients with a history of cerebrovascular disease: a retrospective study in Wuhan

Yang Bai et al. Ann Transl Med. 2021 Jun.

Abstract

Background: Data on patients with coronavirus disease 2019 (COVID-19) who have pre-existing cerebrovascular disease (CVD) are scarce. This study set out to describe the clinical course and outcomes of these patients.

Methods: This single-center retrospective study was performed at Huoshenshan Hospital in Wuhan, China. Patients with confirmed COVID-19 who had pre-existing CVD (N=69) were identified. COVID-19 patients without CVD were randomly selected and matched by age and sex to the patients with CVD. Clinical data were analyzed and compared between the 2 groups. The composite endpoint included intensive care unit admission, use of mechanical ventilation, and death. Multivariable Cox regression analyses with control for medical comorbidities were used to examine the relationship between pre-existing CVD and clinical outcome of COVID-19.

Results: Compared with patients without CVD, patients with pre-existing CVD were more likely to present with unapparent symptoms at first; however, at admission, these patients tended to be in a severer condition than those without CVD, with more underlying hypertension and diabetes. The levels of interleukin-6, creative kinase MB, aspartate transaminase, and creatinine, as well as prothrombin time, were also markedly higher in patients with CVD. Patients with pre-existing CVD were more likely to develop multi-organ dysfunction, deteriorate to critical condition, and yield poorer clinical outcomes than patients without CVD. Concerning therapeutics, greater proportions of patients with pre-existing CVD required mechanical ventilation, higher-order anti-bacterials, and drugs targeting underlying diseases and complications. In the multivariable analysis, pre-existing CVD was significantly associated with a poor clinical outcome.

Conclusions: Patients with a history of CVD are more vulnerable to an over-activated inflammatory response and subsequent multi-organ dysfunction, resulting in a poor clinical outcome. Close monitoring is advisable for these patients.

Keywords: Coronavirus disease 2019 (COVID-19); cerebrovascular disease (CVD); clinical course; clinical outcome; severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm-21-2237). LL serves as an unpaid editorial board member of Annals of Translational Medicine from Apr 2020 to Mar 2022. The authors have no other conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flowchart of patient recruitment.
Figure 2
Figure 2
Disease type (A) and current neurological manifestations (B) of 69 patients with cerebrovascular diseases.
Figure 3
Figure 3
Kaplan-Meier plots for different clinical outcomes in patients with and without pre-existing cerebrovascular diseases. The figure displays Kaplan-Meier survival plots according to disease progression (A), disease deterioration (B), death (C), the composite endpoint (D), and viral clearance (E). CVD, cerebrovascular disease; HR, hazard ratio.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Lu R, Zhao X, Li J, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020;395:565-74. 10.1016/S0140-6736(20)30251-8 - DOI - PMC - PubMed
    1. Coronavirus disease (COVID-19) Weekly Epidemiological Update and Weekly Operational Update. Available online: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situatio.... Date last updated: March 22 2021; Accessed: March 22, 2021.
    1. Blagosklonny MV. From causes of aging to death from COVID-19. Aging (Albany NY) 2020;12:10004-21. 10.18632/aging.103493 - DOI - PMC - PubMed
    1. Guan WJ, Liang WH, Zhao Y, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J 2020;55:2000547. 10.1183/13993003.00547-2020 - DOI - PMC - PubMed
    1. Romagnolo A, Balestrino R, Imbalzano G, et al. Neurological comorbidity and severity of COVID-19. J Neurol 2021;268:762-9. 10.1007/s00415-020-10123-y - DOI - PMC - PubMed