Stroke increases mortality risk in younger patients with COVID-19
Acute ischemic stroke increased the risk for all-cause mortality in young adults with COVID-19 despite a low prevalence in this patient group, according to a study published in The American Journal of Cardiology.
“To our knowledge, this is the first study to report the incidence and outcomes of acute ischemic stroke in young adults with COVID-19 infection,” Frank Annie, PhD, research scientist at Charleston Area Medical Center Institute for Academic Medicine in West Virginia, and colleagues wrote. “We found a low overall incidence but a grim prognosis of acute ischemic stroke among unselected young adults with COVID-19.”
Researchers analyzed data from 9,358 patients younger than 50 years with COVID-19 between Jan. 20 and April 24 who were included in the COVID-19 Research Network database of 37 global health care organizations, 36% of which were in the United States.
Of the patients in this study, 33.2% were hospitalized for severe COVID-19 symptoms.
Acute ischemic stroke occurred in 0.7% of patients. Compared with patients without ischemic stroke, those who had it were more likely to be older (39.3 years vs. 36.7 years; P < .001), although there was a similar proportion of women (60.9% vs. 60.4%; P = .93). In addition, patients with ischemic stroke had a higher prevalence of comorbidities including diabetes (32.8% vs. 6.5%), hypertension (61% vs. 11.7%), HF (15.6% vs. 1.5%), obesity (46.9% vs. 17.4%) and a prior history of stroke (28.1% vs. 0.5%).
Follow-up was conducted for a median of 16.5 days for those with stroke and 36.5 days for those without stroke. During follow-up, all-cause mortality occurred in 15.6% of patients who had an acute ischemic stroke compared with 0.6% of those without stroke.
Researchers also performed a Kaplan-Meier survival analysis, which found that patients who had an acute ischemic stroke had lower odds for survival vs. those without stroke (P for log-rank < .001).
“Due to the nature of this observational database, it is not possible to distinguish whether patients presented with strokes then tested positive for COVID-19 or vice versa,” Annie and colleagues wrote. “Also, given the lack of a control arm without COVID-19, these findings cannot confirm an association between COVID-19 and increased risk of ischemic stroke especially with the higher prevalence of comorbidities in the stroke cohort.”
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