Clinical Characteristics and Outcomes of COVID-19 Patients With a History of Stroke in Wuhan, China

Stroke. 2020 Jul;51(7):2219-2223. doi: 10.1161/STROKEAHA.120.030365. Epub 2020 May 29.

Abstract

Background and purpose: Information on stroke survivors infected with coronavirus disease 2019 (COVID-19) is limited. The aim of this study was to describe specific clinical characteristics and outcomes of patients with COVID-19 with a history of stroke.

Methods: All the confirmed cases of COVID-19 at Tongji Hospital from January 27 to March 5, 2020, were included in our cohort study. Clinical data were analyzed and compared between patients with and without a history of stroke.

Results: Of the included 1875 patients with COVID-19, 50 patients had a history of stroke. The COVID-19 patients with medical history of stroke were older with more comorbidities, had higher neutrophil count, and lower lymphocyte and platelet counts than those without history of stroke. The levels of D-dimers, cardiac troponin I, NT pro-brain natriuretic peptide, and interleukin-6 were also markedly higher in patients with history of stroke. Stroke survivors who underwent COVID-19 developed more acute respiratory distress syndrome and received more noninvasive mechanical ventilation. Data from propensity-matched analysis indicated a higher proportion of patients with COVD-19 with a history of stroke were admitted to the intensive care unit requiring mechanical ventilation and were more likely to be held in the unit or die, compared with non-stroke history COVID-19 patients.

Conclusions: Patients with COVID-19 with a history of stroke had more severe clinical symptoms and poorer outcomes compared with those without a history of stroke.

Keywords: COVID-19; cardiovascular disease; comorbidity; platelet count; troponin I.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Betacoronavirus*
  • Blood Cell Count
  • China / epidemiology
  • Comorbidity
  • Coronavirus Infections* / epidemiology
  • Female
  • Hospital Mortality
  • Hospitals, University / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Pandemics*
  • Pneumonia, Viral* / epidemiology
  • Procedures and Techniques Utilization
  • Propensity Score
  • Recurrence
  • Respiration, Artificial / statistics & numerical data
  • Respiratory Distress Syndrome, Adult / etiology
  • Respiratory Distress Syndrome, Adult / therapy
  • Stroke / blood
  • Stroke / epidemiology*
  • Stroke / therapy
  • Treatment Outcome

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2