Stroke Is A Greater Risk With Severe COVID-19 Than Other, Similar Infections

With all of the dire consequences from having a severe case of COVID-19, hospitalized patients also face a higher risk of stroke, compared to inpatients with similar infections. Find out which COVID-19 patients are most at risk and that increased their likelihood of suffering stroke.

SEATTLE, WA – Patients hospitalized with COVID-19 suffered a higher risk of stroke compared to those with similar infectious conditions such as influenza and sepsis, according to a new study.

The presentation at the American Stroke Association International Stroke Conference adds that patients developing ischemic stroke were more likely to be older, male, Black race, or have high blood pressure, Type 2 diabetes or atrial fibrillation, compared with other COVID-19 patients. In-hospital deaths also were found to be more than twice as high among stroke patients (37%) compared to patients without stroke (16%).

University of Washington-led researchers used the American Heart Association’s COVID-19 Cardiovascular Disease Registry for analysis, accessing data on more than 20,000 patients’ demographic characteristics, medical histories and in-hospital survival. Participants were hospitalized in the United States between January and November 2020.

“These findings suggest that COVID-19 may increase the risk for stroke, though the exact mechanism for this is still unknown,” explained lead study author Saate S. Shakil, MD, a cardiology fellow at the University of Washington in Seattle. “As the pandemic continues, we are finding that coronavirus is not just a respiratory illness, but a vascular disease that can affect many organ systems.”

Among the patients, 281 (1.4%) in the COVID-19 CVD Registry had a stroke confirmed by diagnostic imaging during hospitalization. Most 52.7%, experienced ischemic stroke; 45.2% had a bleeding or unspecified type of stroke and a few, 2.5%, had transient ischemic attacks. Researchers report that patients who had a stroke spent an average of 22 days in the hospital, compared to 10 days of hospitalization for those without stroke.

Study authors also point out that certain characteristics were more associated with stroke in the COVID-19 patients, including that:

• Those with any type of stroke were more likely to be male (64%) and older (average age 65) than patients without stroke (average age 61);
• 44% of patients who had an ischemic stroke also had Type 2 diabetes vs. about one-third of patients without stroke, and most of the ischemic stroke patients had high blood pressure (80%) compared to patients without stroke (58%);
• 18% of ischemic stroke patients had atrial fibrillation, while 9% of those without stroke also had atrial fibrillation;

Race also was identified as an important factor in stroke risk, with Black patients accounting for 27% of the patients in the COVID-19 CVD Registry pool for this analysis but 31% of the ischemic stroke cases.

“We know the COVID-19 pandemic has disproportionately affected communities of color, but our research suggests Black Americans may have higher risk of ischemic stroke after contracting the virus, as well,” Shakil said. “Stroke on its own can have devastating consequences and recovering from COVID-19 is often a difficult path for those who survive. Together, they can exact a significant toll on patients who have had both conditions.”

The COVID-19 CVD Registry was created by AHA within weeks of the declaration of the global pandemic to rapidly collect and provide insights into patients hospitalized with the novel coronavirus. In addition, the organizations Get With the Guidelines registry infrastructure has allowed for rapid data collection, including over 37,000 patient records and more than 135,000 lab reports, with more than 160 registry sites enrolled.