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Risk for Acute Cerebrovascular Events Low in COVID-19 Patients

In hospitalized patients with COVID-19, 2.4 percent had confirmed ischemic stroke, 0.9 percent had ICH

MONDAY, Aug. 3, 2020 (HealthDay News) — For hospitalized COVID-19 patients, the risk for acute cerebrovascular events is low, according to a study published online July 20 in Stroke.

Aaron Rothstein, M.D., 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 three hospitals in Philadelphia.

The researchers found that 20 of 844 hospitalized patients with COVID-19 had confirmed ischemic stroke (2.4 percent) and eight (0.9 percent) had intracranial hemorrhage. Eighty percent of the patients with ischemic stroke were black. Conventional vascular risk factors were common, with 95 and 60 percent 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 percent, respectively. Three of 11 patients (27 percent) with complete vascular imaging had large vessel occlusion. More than 75 percent of tested patients had newly positive antiphospholipid antibodies. Overall, five and three of eight patients with intracranial hemorrhage had lobar intraparenchymal hemorrhages and subarachnoid hemorrhage, respectively; four 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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