Abstract Details

Title COVID-19 Infection is Associated with Stroke Subtype, Severity, and Outcomes in Patients with Acute Ischemic Stroke

Topic General Neurology

Presentation(s) P8 - Poster Session 8 (8:00 AM-9:00 AM)

Poster/Presentation
Number 11-017

Objective To determine differences in patient demographics and stroke sub-type by COVID status at a US comprehensive stroke center.

Background In patients with severe COVID-19 infection there is an increased risk of cerebrovascular events, including acute ischemic stroke (AIS). In patients who present with COVID-19 infection and AIS, certain stroke subtypes have been reported with greater frequency.

Design/Methods We retrospectively evaluated adults (≥18) with AIS admitted during the first year of the COVID pandemic (3/1/2020 – 3/1/2021). Pearson chi-square tests were used to compared COVID+ vs COVID– patients for demographics (age, sex, race, comorbidities), stroke subtype (TOAST classification), severe stroke (NIHSS≥21), management (intravenous and intraarterial therapy [IVT and IAT]), and outcomes (in-hospital mortality and independent at discharge [mRS 0-2]).

Results Forty-four percent (475 of 1,086 AIS patients) were evaluated for COVID-19; most patients (94%) had PCR testing. Thirty-five (7%) patients were COVID+ and 441 (93%) were COVID–. Patients who were COVID+ were more likely to have cryptogenic stroke (62% vs. 32%, p<0.001), were more likely to report previous COVID infection (19% vs. 2%, p<0.001), were more likely to receive IVT (41% vs. 24%, p=0.03), and were less likely to be non-Hispanic white (53% vs. 71%, p=0.02) compared to COVID– patients. In-hospital mortality was significantly greater in COVID+ versus COVID– patients (12% vs. 4%, p=0.03); however, mRS 0-2 was similar: 29% vs. 27%. When comparing symptomatic (n=10) and asymptomatic (n=24) COVID+ patients, symptomatic patients were more likely to present with severe stroke (41% vs. 0%, p=0.03) and less likely to have mRS 0-2 (17% vs. 60%, p=0.04); there were no other demographic or clinical differences by symptomatology.

Conclusions Stroke etiology, stroke severity, and clinical outcomes can differ significantly based on COVID status. Patients with AIS and symptomatic COVID also have worse stroke severity and neurologic disability at discharge.

Authors/Disclosures
Anna Belits, DO PRESENTER	Dr. Belits has nothing to disclose.
Ian Rankine, DO (HealthONE Neurology Residency)	Dr. Rankine has nothing to disclose.
Kristin Salottolo, MPH	Ms. Salottolo has nothing to disclose.
Katie Higgins, MD (HealthONE)	Dr. Higgins has nothing to disclose.
Frank Wang, DO	Dr. Wang has nothing to disclose.
DaYoung Kim, DO (HCA)	Dr. Kim has nothing to disclose.
Yasaman Pirahanchi, MD (Brigham and Women's Hospital)	Dr. Pirahanchi has nothing to disclose.
David Bar-Or	David Bar-Or has received intellectual property interests from a discovery or technology relating to health care.
Christian J. Burrell, MD (Blue Sky Neurology)	Dr. Burrell has nothing to disclose.

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