By Frank Long, Editorial Director
It’s official: COVID-19 infection is an independent risk factor for acute ischemic stroke.
The proclamation comes from a recent New York City-based study titled COVID-19 Is an Independent Risk Factor for Acute Ischemic Stroke. The research was conducted between March 16 and April 5 and evaluated 41 cases and 82 control subjects. Results of that study were published June 25 in the peer-reviewed American Journal of Neuroradiology.
Study authors concluded that patients diagnosed with COVID-19 should be evaluated early for acute neurologic changes.
Timely workup, the study authors added, should be performed among patients who are suspected of having stroke as a way to reduce morbidity and mortality.
First of Its Kind
According to study leader, Puneet Belani, MD, Assistant Professor at Ichan School of Medicine at Mount Sinai Health System, Dept. of Radiology, Neuroradiology, the research is the first major peer-reviewed study to establish that COVID-19 is a risk factor for acute stroke.
“In a study of 123 patients presenting to our New York City Hospital System for suspicion of stroke during the COVID-19 pandemic from March to April 2020, we showed that COVID-19 infection is significantly associated with strokes,” Belani says.
Belani points out that individuals selected for the study were matched by age, gender, and the number of major vascular risk factors. Those individuals were compared against controls whose imaging and clinical findings were inconsistent with acute ischemic infarct.
An Independent Threat
Previous research has established the known threat of respiratory infections on short-term risk of ischemic stroke. Recent cases in China reported that neurologic symptoms are observed in approximately 36% of patients in that country who are hospitalized with COVID-19.
The relationship between COVID-19 and acute stroke was solidified when Belani and his team found that COVID-19 infection had a significant independent association with acute ischemic stroke compared with control subjects.
After we adjusted for age, sex, and major vascular risk factors, COVID-19 infection was found to be independently and significantly associated with patients with acute ischemic stroke compared with control subjects with an OR of 3.9 (95% CI, 1.7–8.9; P 1⁄4 .001).“COVID-19 Is an Independent Risk Factor for Acute Ischemic Stroke” — Belani P, Schefflein J. Kihira S, et al
Authors of the study acknowledge that a large number of patients affected by COVID-19 have underlying vascular disease but point out that the increased morbidity and mortality associated with a COVID-19 infection transcends the primary cardiopulmonary sequelae that results from infection.
Belani and the study team recommend efforts focused on future research that can determine whether the same associations stand firm for large-vessel and small vessel strokes.
Learn more about the associations between stroke and COVID-19: “Troubling Link Between Coronavirus and Stroke in Otherwise Healthy Young People“