Greater Frequency of Stroke in Men With COVID-19 and High Comorbidity Burden

 Strokes among patients with COVID-19 were more prevalent in older men with increased burden from comorbidities. These findings were presented during the International Stroke Conference, held remotely March 17-19, 2021.

Study researchers assessed patients (N=15,399) with COVID-19 who were hospitalized at 104 institutions between January and September 2020 and enrolled in the American Heart Association COVID-19 Cardiovascular Disease Registry. They analyzed demographic and baseline clinical characteristics associated with instances of ischemic stroke, transient ischemic attack, or other strokes.

A total of 201 (1.3%) patients had a diagnostic image-confirmed in-hospital stroke. Among these patients, 54.2% had an ischemic stroke, 2.0% had a transient ischemic attack, and 0.6% had other strokes. While Black patients made up 27% of the registry, findings indicated that this population accounted for 38.3% of transient ischemic attack and stroke.

Stratified by stroke, patients who had ischemic stroke or transient ischemic attack, other strokes, or no stroke differed significantly for the demographic characteristics of age (mean, 65.7 vs 65.0 vs 61.2 years; P =.005), gender (women: 33.9% vs 35.9% vs 45.6%; P =.016), and race/ethnicity (Black: 38.3% vs 27.2% vs 26.0%; P =.035), respectively. The rates among these groups differed for hypertension (83.5% vs 60.9% vs 57.8%; P <.0001), atrial fibrillation (23.0% vs 9.8% vs 8.8%; P <.0001), cerebrovascular disease (21.7% vs 27.2% vs 12.8%; P =.007), and diabetes (47.0% vs 39.1% vs 35.3%; P =.011), respectively.

During hospitalization, patients differed significantly for transfer to intensive care unit (73.0% vs 83.7% vs 29.8%; P <.0001), mechanical ventilation (60.0% vs 63.0% vs 19.8%; P <.0001), renal replacement (18.3% vs 18.5% vs 4.0% ; P <.0001), seizure (5.2% vs 10.9% vs 0.7%; P <.0001), length of hospital stay (mean, 22.1±22.3 vs 24.4±22.8 vs 9.8±11.0 days; P <.0001), and in-hospital mortality (35.7% vs 35.9% vs 16.1%; P <.0001) on the basis of ischemic stroke or transient ischemic attack, other strokes, or no stroke, respectively.

Study researchers concluded that patients with COVID-19 “with stroke were older and more likely to be men than those without stroke. Those with ischemic stroke and TIA had higher prevalence of hypertension, diabetes and atrial fibrillation compared with the other groups, and stroke rates varied by race.”

Disclosure: Multiple authors declared affiliations with the pharmaceutical industry. Please refer to the original article for a full list of disclosures.

Reference

Shakil SS, Emmons-bell S, Rutan C, et al. Stroke among patients hospitalized with COVID-19 in the United States: Results from the AHA COVID-19 Cardiovascular Disease Registry. Presented at the International Stroke Conference. 2021. Presentation LB12