Influencing factors of early neurological deterioration in COVID-19 -associated acute ischemic stroke

Abstract

Background: COVID-19 contributes to dysfunction and increased mortality in patients with acute ischemic stroke (AIS). However, whether COVID-19 causes early neurological deterioration (END) in patients with AIS and its underlying influencing factors are currently unclear.To ascertain the autonomous risk factors associated with END in stroke cases related to COVID-19. Methods: This is a retrospective observational study of data collected from November 2022 to February 2023 from patients with AIS complicated with COVID-19. The patients were divided into non-END and END groups, and their demographic characteristics, laboratory and imaging data were analyzed to investigate the risk factors for END in AIS patients complicated with COVID-19. Results: A total of 83 patients were enrolled in this study, and divided in to END (n = 22) and non-END (n = 61) groups. We found that patients with high baseline NIHSS score (P = 0.044), preexisting diabetes (P < 0.01), stroke (P < 0.01) and abnormal electrocardiogram (P < 0.01) were prone to END. Compared to patients with non-END, serum hs-CRP (P < 0.01), hs-cTn (P < 0.01), PT (P < 0.01), and DD (P < 0.01) were obviously increased in patients with EDN. Furthermore, multivariate Logistic regression analysis identified preexisting diabetes, stroke, high baseline NIHSS score, abnormal electrocardiogram, prolonged PT value, increased hs-CRP and elevated DD as independent risk factors for ENG in COVID-19-associated AIS. Conclusions: Patients with preexisting diabetes, stroke, high baseline NIHSS score, abnormal electrocardiogram, prolonged serum PT value, significantly increased hs-CRP and DD are prone to END in COVID-19-associated AIS.