Objective:

To determine if elevated inflammatory markers are associated with worse functional outcomes in SARS-CoV-2 positive patients presenting with acute cerebrovascular events. 

Background:

The association of acute Coronavirus disease 2019 (COVID-19) with both arterial and venous thromboembolic events is well-established. One of the several proposed mechanisms is excessive inflammatory response. We aim to assess if higher inflammatory markers are associated with worse functional outcomes 

Design/Methods:

Medical records of adult patients admitted to our institution between 3/2020 and 8/2021 with positive SARS-COV-2 and acute cerebrovascular events were reviewed (n=29). Demographics, neuroradiological and pertinent lab findings were collected. Functional outcomes were assessed using binarized mRS scores (worse 4-6 vs better 0-3) ascertained on discharge day.  A series of logistic regression models were utilized to assess the association of inflammatory markers with stroke outcomes. Variables assessed were; [admission day heart rate, temperature and white blood cell count], binarized maximum procalcitonin ( > 0.1 ng/mL vs </= 0.1 ng/mL) and maximum ferritin level. All analyses were conducted using SAS software. 

Results:

Among 29 patients (mean age 63.6 +/- 13.4 years, 65.5% males), tested parameters of inflammation were not shown to be significantly associated with stroke outcomes in an adjusted logistic regression model. When assessing stroke outcome via binarized modified Rankin stroke scale, binarized maximum procalcitonin level showed 1.95 times the odds of a poor outcome (OR: 1.95, 95% CI: 0.05, 84.3, p-value: 0.73). Additionally, temperature on admission showed 1.59 times the odds of a poor outcome (OR: 1.59, 95% CI: 0.42, 6.07, p-value: 0.17). 

Conclusions:

Among patients with acute cerebrovascular events associated with positive SARS-COV-2 result, no significant associations of worse functional outcomes in those with elevated inflammatory markers were observed. A trend of higher mRS scores on discharge in those with elevated procalcitonin and those with fever on admission was noted. Further research is needed to confirm these findings