Stroke in patients with COVID-19 diagnosis in a Public National Hospital

Abstract

Infection by the new coronavirus (SARS-CoV-2) causes a multisystemic disorder, being the main manifestations in the respiratory system. However, neurological manifestations have been reported showing an increased incidence of ischemic or hemorrhagic stroke. A retrospective study (January, February and March 2021), in the database of “Hospital Nacional El Salvador” in order to detect and describe the findings in admitted patients who required Brain Computed Tomography (CT) scan due to Acute Neurological manifestations during their hospitalization. Objective: To describe de incidence of stroke in COVID-19 patient admitted to Hospital El Salvador compare to El Salvador population. Methods: Observational cross-sectional study in January, February and March 2021 at “Hospital Nacional El Salvador” designated as COVID Hospital to face the Pandemic. The epidemiological data, images, and reports from the Radiology Department of all patients admitted to the hospital were obtained via the electronic database “Patient Care Integral System” (“Sistema Integral de Atención al Paciente” - SIAP). The following definitions were stablished: 1. Normal CT, 2. Abnormal CT; highlighting the presence of ischemic or hemorrhagic stroke. The Study was approved by the Research Ethics Committee. Results: During the period studied, a total of 3,632 patients with clinical diagnosis of COVID-19 were registered. CT scan was required for 87 (2.4%) patients, of whom 74 (2.04%) presented some type of abnormality; 20 (27.02%) of the abnormal CT scans had findings corresponding to a stroke (ischemic or hemorrhagic); this represents an incidence of 0.55% of the total patients assisted in this period. The age-adjusted global mortality rate from cerebrovascular diseases (2014, updated 2018) is 25.2 per 100,000 inhabitants; our finding would indicate an increase in the expected rate of stroke compared to general population. Conclusion: Coinciding with other reports, we found that the disease COVID-19 has a higher incidence of stroke in hospitalized patients older than 60 years.