2026 American Academy of Neurology Abstract Website

Suhaib Alquraan¹, Ahmed Yassin², Sohaib Alomari¹, Ghassab Ababneh¹, Malik Allahham², Mays Khweileh³, Malak Albattah⁴, Duaa Khasawneh⁵, Mahmoud Alquraan⁶, Khalid El-Salem², Ola Soudah⁷
¹Faculty of Medicine, Jordan University of Science and Technology, ²Department of Neurology, Jordan University of Science and Technology, ³Department of Neurology, Duke University, ⁴Department of Neurology, Louisiana State University, ⁵Department of Neurology, Princess Basma Hospital, ⁶Department of Applied Psychology, Al Ain university, ⁷Faculty of Medicine, Yarmouk University

Objective:

To determine predictors of acute stroke among COVID-19 inpatients with delirium.

Background:

Delirium in hospitalized patients with COVID-19 is one of the common neurological presentations. Among the important causes of that is acute stroke, the diagnosis of which requires brain imaging like CT and MRI. Carefully selecting which patients get such images is mandatory to avoid unnecessary exposure of personnel to COVID-19 and injudicious use of resources while avoiding missing such an important complication.

Design/Methods:

We reviewed medical charts at a tertiary hospital of patients with PCR-confirmed COVID-19, seen by neurology for delirium and underwent brain CT or MRI, from October 2020 to August 2021. Patients with acute stroke on the CT/MRI were compared with those with negative images. About fifty clinical or laboratory features were screened with univariate analysis and those with p<0.20 entered multivariate logistic regression. Discrimination was summarized by the area under the ROC curve.

Results:

Records of 97 COVID-19 patients with delirium were screened, 67 of them had brain imaging and entered the analysis. 23 (34.3%) patients were found to have an acute stroke on their images. Four significant independent predictors of acute stroke were found and these included focal neurological deficit (OR 10.09, 95% CI 1.16–87.48), respiratory symptoms (OR 8.18, 95% CI 1.16–57.52), ESR (OR 0.96, 95% CI 0.93–0.99), and D-dimer (OR 1.24, 95% CI 1.01–1.53). The overall discrimination was excellent with area under the curve (AUC) of 0.92.

Conclusions:

In COVID-19 patients with delirium, focal neurologic deficit and respiratory symptoms, and to a lesser extent, lower ESR and higher D-dimer levels are significant predictors of acute stroke. Doing brain imaging (CT/MRI) for patients with such risk factors is warranted.