HealthDay News — For hospitalized COVID-19 patients, the risk for acute cerebrovascular events is low, according to a study published online in Stroke.

Aaron Rothstein, MD, from the University of Pennsylvania in Philadelphia, and colleagues conducted a retrospective study to examine stroke incidence and mechanisms in patients with COVID-19 hospitalized from March 15 to May 3, 2020, at 3 hospitals in Philadelphia.

The researchers found that 20 of 844 hospitalized patients with COVID-19 had confirmed ischemic stroke (2.4%) and 8 (0.9%) had intracranial hemorrhage. Eighty percent of the patients with ischemic stroke were Black. Conventional vascular risk factors were common, with 95% and 60% having a history of hypertension and diabetes mellitus, respectively. There were a median of 21 days from the onset of COVID-19 symptoms to stroke diagnosis. The mechanism of stroke was cardioembolism, small vessel disease, other determined mechanism, and cryptogenic in 40%, 5%, 20%, and 35%, respectively. Three of 11 patients (27%) with complete vascular imaging had large vessel occlusion. More than 75% of tested patients had newly positive antiphospholipid antibodies. Overall, 5 and 3 of 8 patients with intracranial hemorrhage had lobar intraparenchymal hemorrhages and subarachnoid hemorrhage, respectively; 4 patients were on extracorporeal membrane oxygenation.

“Both ischemic stroke and intracranial hemorrhage occur in patients with COVID-19 but are relatively infrequent,” the authors write. “Most patients with ischemic stroke had conventional vascular risk factors.”


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