J Res Med Sci . New-onset acute ischemic stroke following COVID-19: A case-control study

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J Res Med Sci


. 2022 Apr 15;27:31.
doi: 10.4103/jrms.jrms_255_21. eCollection 2022.
New-onset acute ischemic stroke following COVID-19: A case-control study


Fariborz Khorvash ¹ , Mohammad Amin Najafi ¹ , Mohsen Kheradmand ¹ , Mohammad Saadatnia ¹ , Rojin Chegini ² , Farideh Najafi ³



Affiliations

• PMID: 35548177
• PMCID: PMC9081507
• DOI: 10.4103/jrms.jrms_255_21

Abstract

Background: Neurological manifestations of coronavirus disease 2019 (COVID-19) have been highlighted. COVID-19 potentially increases the risk of thromboembolism. We aimed to compare patients with COVID-19 with and without new-onset acute ischemic stroke (AIS).
Materials and methods: In this single-center retrospective case-control study, demographics, clinical characteristics, laboratory findings, and clinical outcomes were compared between 51 patients with both COVID-19 and AIS (group A) and 160 patients with COVID-19 and without AIS (group B).
Results: Patients in group A were significantly older, more likely to present with critical COVID-19 (P = 0.004), had higher rates of admission in the intensive care unit (P < 0.001), more duration of hospitalization (P < 0.001), and higher in-hospital mortality (P < 0.001). At the time of hospitalization, O₂ saturation (P = 0.011), PH (P = 0.04), and HCO3 (P = 0.005) were lower in group A. White blood cell count (P = 0.002), neutrophil count (P < 0.001), neutrophil-lymphocyte ratio (P = 0.001), D-Dimer (P < 0.001), blood urea nitrogen (BUN) (P < 0.001), and BUN/Cr ratio (P < 0.001) were significantly higher in patients with AIS.
Conclusion: Stroke in COVID-19 is multifactorial. In addition to conventional risk factors of ischemic stroke (age and cardiovascular risk factors), we found that patients with more severe COVID-19 are more prone to ischemic stroke. Furthermore, leukocyte count, neutrophil count, neutrophil-lymphocyte ratio, D-Dimer, BUN, and BUN/Cr ratio were higher in patients with AIS following COVID-19 infection.

Keywords: Acute ischemic stroke; D-dimer; blood urea nitrogen; coronavirus disease 2019.