Objective:

To describe demographic, clinical characteristics and outcomes of patients experiencing stroke with concomitant COVID-19 infection in a community-based teaching hospital.

Background:

It has been proven that COVID-19 patients are at risk of developing ischemic stroke due to mechanisms including embolic phenomenon from a hypercoagulable state, vasculitis, and cardiomyopathy. We aim to describe incidence of stroke, radiographic patterns and timing of stroke in relation to COVID-19 infection specifically in West Michigan. 

Design/Methods:

We conducted a single centre descriptive case series of patients with stroke and concomitant COVID-19 infection between March 2020 and December 2021. Data collected included demographic and clinical characteristics, time between COVID diagnosis and stroke and discharge disposition. Summary statistics are reported. 

Results:

A total of 50 patients were reviewed; average age 68.9+16.3 years, 50% male and predominantly white 85.7% (36/42). Thirty-nine patients were diagnosed with stroke at admission and 11 patients experienced stroke post-admission. Forty-two (84%) patients were diagnosed with COVID-19 within two weeks prior to or after stroke; with 70% occurring within 7 days. Eight patients were diagnosed with COVID-19 within a median of 20 days prior to or after stroke (range: 16-51 days). Thirty-seven patients had documented COVID-19 severity, 17 (46%) had moderate to critically severe illness. Thirty-eight (76%) patients had documented hypertension. Thirty-one (62%) patients experienced embolic stroke. Five patients died, 18 were discharged home and 27 were discharged to rehab or a long-term care facility. 

Conclusions:

Like other findings in the literature, there appears to be a high incidence of stroke within 14 days of COVID infection, with most occurring within one week of diagnosis. Most of the strokes were embolic in nature. Most patients had severe symptoms of covid as well.