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Stroke
03, 2021;52 (3): 905-912.

Acute Ischemic Stroke and COVID-19: An Analysis of 27 676 Patients.

Adnan I Qureshi, William I Baskett, Wei Huang, Daniel Shyu, Danny Myers, Murugesan Raju, Iryna Lobanova, M Fareed K Suri, S Hasan Naqvi, Brandi R French, Farhan Siddiq, Camilo R Gomez, Chi-Ren Shyu
Author Information
  1. Adnan I Qureshi: Zeenat Qureshi Institute, St Cloud, MN (A.I.Q, W.H., I.L.).
  2. William I Baskett: Institute for Data Science and Informatics (W.I.B., M.R., C.-R.S.), University of Missouri, Columbia.
  3. Wei Huang: Zeenat Qureshi Institute, St Cloud, MN (A.I.Q, W.H., I.L.).
  4. Daniel Shyu: Department of Medicine (D.S.), University of Missouri, Columbia.
  5. Danny Myers: Tiger Institute for Health Innovation, Cerner Corporation, Columbia, MO (D.M.).
  6. Murugesan Raju: Institute for Data Science and Informatics (W.I.B., M.R., C.-R.S.), University of Missouri, Columbia.
  7. Iryna Lobanova: Department of Neurology (A.I.Q., W.H., I.L., B.R.F., C.R.G.), University of Missouri, Columbia.
  8. M Fareed K Suri: St. Cloud Hospital, MN (M.F.K.S.).
  9. S Hasan Naqvi: Department of Internal Medicine (S.H.N.), University of Missouri, Columbia.
  10. Brandi R French: Department of Neurology (A.I.Q., W.H., I.L., B.R.F., C.R.G.), University of Missouri, Columbia.
  11. Farhan Siddiq: Division of Neurosurgery (F.S.), University of Missouri, Columbia.
  12. Camilo R Gomez: Department of Neurology (A.I.Q., W.H., I.L., B.R.F., C.R.G.), University of Missouri, Columbia.
  13. Chi-Ren Shyu: Institute for Data Science and Informatics (W.I.B., M.R., C.-R.S.), University of Missouri, Columbia.
PMID: 33535779 DOI: 10.1161/STROKEAHA.120.031786

Abstract

BACKGROUND AND PURPOSE: Acute ischemic stroke may occur in patients with coronavirus disease 2019 (COVID-19), but risk factors, in-hospital events, and outcomes are not well studied in large cohorts. We identified risk factors, comorbidities, and outcomes in patients with COVID-19 with or without acute ischemic stroke and compared with patients without COVID-19 and acute ischemic stroke.
METHODS: We analyzed the data from 54 health care facilities using the Cerner deidentified COVID-19 dataset. The dataset included patients with an emergency department or inpatient encounter with discharge diagnoses codes that could be associated to suspicion of or exposure to COVID-19 or confirmed COVID-19.
RESULTS: A total of 103 (1.3%) patients developed acute ischemic stroke among 8163 patients with COVID-19. Among all patients with COVID-19, the proportion of patients with hypertension, diabetes, hyperlipidemia, atrial fibrillation, and congestive heart failure was significantly higher among those with acute ischemic stroke. Acute ischemic stroke was associated with discharge to destination other than home or death (relative risk, 2.1 [95% CI, 1.6-2.4]; <0.0001) after adjusting for potential confounders. A total of 199 (1.0%) patients developed acute ischemic stroke among 19 513 patients without COVID-19. Among all ischemic stroke patients, COVID-19 was associated with discharge to destination other than home or death (relative risk, 1.2 [95% CI, 1.0-1.3]; =0.03) after adjusting for potential confounders.
CONCLUSIONS: Acute ischemic stroke was infrequent in patients with COVID-19 and usually occurs in the presence of other cardiovascular risk factors. The risk of discharge to destination other than home or death increased 2-fold with occurrence of acute ischemic stroke in patients with COVID-19.

Keywords

coronavirus death electronic health records ischemic stroke morbidity

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Grants

  1. 5T32LM012410/NIH HHS

MeSH Term

Acute Kidney Injury
Adult
Black or African American
Aged
Aged, 80 and over
Atrial Fibrillation
Brain Edema
COVID-19
Cerebral Hemorrhage
Cohort Studies
Comorbidity
Diabetes Mellitus
Female
Heart Failure
Hispanic or Latino
Hospital Mortality
Hospitals, Rehabilitation
Humans
Hyperlipidemias
Hypertension
Ischemic Stroke
Liver Failure
Male
Middle Aged
Myocardial Infarction
Nursing Homes
Patient Discharge
Respiratory Insufficiency
Retrospective Studies
Risk Factors
SARS-CoV-2
Skilled Nursing Facilities
United States
White People
Journal Article Research Support, N.I.H., Extramural

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