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Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study

Yanan LiDepartment of Neurology Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaMan LiDepartment of Neurology Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaMengdie WangDepartment of Neurology Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaYifan ZhouDepartment of Neurology Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaJiang ChangDepartment of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaYing XianDuke Clinical Research Institute and Department of Neurology, Duke University Medical Center, Durham, North Carolina, USADavid WangNeurovascular Division, Department of Neurology, Barrow Neurological Institute/Saint Joseph Hospital Medical Center, Phoenix, Arizona, USALing MaoDepartment of Neurology Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHuijuan JinDepartment of Neurology Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaBo HuDepartment of Neurology Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2020en

ABI

Annotatsiya

BACKGROUND AND PURPOSE: COVID-19 is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Apart from respiratory complications, acute cerebrovascular disease (CVD) has been observed in some patients with COVID-19. Therefore, we described the clinical characteristics, laboratory features, treatment and outcomes of CVD complicating SARS-CoV-2 infection. MATERIALS AND METHODS: Demographic and clinical characteristics, laboratory findings, treatments and clinical outcomes were collected and analysed. Clinical characteristics and laboratory findings of patients with COVID-19 with or without new-onset CVD were compared. RESULTS: Of 219 patients with COVID-19, 10 (4.6%) developed acute ischaemic stroke and 1 (0.5%) had intracerebral haemorrhage. COVID-19 with new onset of CVD were significantly older (75.7±10.8 years vs 52.1±15.3 years, p<0.001), more likely to present with severe COVID-19 (81.8% vs 39.9%, p<0.01) and were more likely to have cardiovascular risk factors, including hypertension, diabetes and medical history of CVD (all p<0.05). In addition, they were more likely to have increased inflammatory response and hypercoagulable state as reflected in C reactive protein (51.1 (1.3-127.9) vs 12.1 (0.1-212.0) mg/L, p<0.05) and D-dimer (6.9 (0.3-20.0) vs 0.5 (0.1-20.0) mg/L, p<0.001). Of 10 patients with ischemic stroke; 6 received antiplatelet treatment with aspirin or clopidogrel; and 3 of them died. The other four patients received anticoagulant treatment with enoxaparin and 2 of them died. As of 24 March 2020, six patients with CVD died (54.5%). CONCLUSION: Acute CVD is not uncommon in COVID-19. Our findings suggest that older patients with risk factors are more likely to develop CVD. The development of CVD is an important negative prognostic factor which requires further study to identify optimal management strategy to combat the COVID-19 outbreak.

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DOI: 10.1136/svn-2020-000431

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