Characteristics and comparisons of acute stroke in “recovered" to “active COVID-19 and “pre-pandemic” in Qatar database

Abstract

Understanding the relationship of COVID-19 to stroke is important. We compare characteristics of pre-pandemic stroke (PPS), cases in acute COVID infection (CS) and in patients who have recovered from COVID-19 infection (RCS). We interrogated the Qatar stroke database for all stroke admissions between Jan 2020 and Feb 2021 (PPS) to CS and RCS to determine how COVID-19 affected ischemic stroke sub-types, clinical course, and outcomes prior to, during and post-pandemic peak. There were 3264 cases admitted (pre-pandemic: 3111, stroke in COVID-19: 60 and recovered COVID-19 stroke: 93). Patients with CS were significantly younger, had more severe symptoms, fever on presentation, more ICU admissions and poor stroke recovery at discharge when compared to PPS and RCS. Large vessel disease and cardioembolic disease was significantly higher in CS compared to PPS or RCS. There was a significant decline in stroke mimics in CS. Stroke in RCS has characteristics similar to PPS with no evidence of lasting effects of the virus on the short-term. However, CS is a more serious disease and tends to be more severe and have a poor prognosis.

Clinical characteristics of COVID-19 associated vasculopathic diseases

“…Another study evaluating outcome data of patients with COVID-19 associated stroke revealed a significantly elevated in-hospital mortality compared to COVID-19 patients without stroke (19.4% vs. 6.2%) with an increased risk for the development of cerebral edema, intracerebral hemorrhage, and myocardial infarction [ 82 , 86 , 87 ]. Additionally, COVID-19 associated stroke was associated with higher rates of ICU admission and intubation compared to stroke patients without COVID-19 [ 88 ]. Moreover, Hernández-Fernández et al [ 89 ] revealed that COVID-19 associated stroke patients may exhibit longer hospitalization rates, slower recovery times and unfavorable functional prognosis evaluated by the modified Rankin Scale in over 64% of cases.…”