Ischemic stroke in COVID- 19 patients: Single center, one year experience

Abstract

INTRODUCTION: The clinical presentation of COVID-19 varies greatly. Even though, disease cause predominantly respiratory manifestations, because of the inflammatory nature of the disease, it also triggers thromboembolic conditions. We aim to describe the features of COVID-19 positive ischemic stroke patients of 1-year experiences of a single center. METHOD(S): A total of 258 patients, diagnosed with ischemic cerebrovascular disease (25 patients of with strokes had respiratory symptoms at initial presentation and COVID-19 diagnosis), were evaluated retrospectively during the study period. RESULT(S): A majority of these patients strokes were in anterior circulation territory and most of them were large vessel occlusion. Eighteen of the patients had positive COVID-19 RT-PCR results, while 7 of the patients had negative results but their thorax CTs made the diagnosis of COVID-19. Hypertension (56%), diabetes (44%), and atrial fibrillation (44%) were the most comorbidities. Thirteen patients stroke etiology was cardioembolism, 9 had atherosclerosis. Fourteen of the patients NIHSS were >10, and 13 of them died. Patients with high levels of CRP (13/25), D-Dimer (15/25) and Ferritin (14/25) had mRS>3 at admission. Most of the patients (19/25) had CO-RADS 5 scores at admission. Two patients had mRS 4-5, 9 patients had mRS 0-3 at the discharge period. Fourteen patients died at the hospital period. DISCUSSION AND CONCLUSION(S): The admission NIHSS scores determined significantly the prognosis. Moreover, higher age, women gender, LVO in neuroimagining, high CRP, Ferritin, D-dimer levels, COVID-19 RT-PCR positivity, presence of hypertension and atrial fibrillation comorbidities showed poor outcome.Copyright © 2022 by Turkish Cerebrovascular Diseases Society