Strokes in Covid-19 patients: Four studies capture trends

How frequent, and how severe, are strokes among Covid-19 patients? A series of papers in the journal Stroke, published by the American Heart Association, examines trends from four countries.

How frequent, and how severe, are strokes among Covid-19 patients? A series of papers in the journal Stroke, published by the American Heart Association, examines trends from four countries. The broad findings:

* The rate of strokes in Covid-19 patients appears relatively low; but —

* A higher proportion of those strokes are among younger people;

* The strokes in Covid-19 patients are often more severe compared to strokes in people who do not have the novel coronavirus, while global rates for stroke hospitalisations and treatments are significantly lower than for the first part of 2019.

One study, covering New York between March 15 and April 19, found that out of 3,556 hospitalised Covid cases, 32 patients (0.9%) had ischemic stroke. They compared those 32 Covid patients to those admitted only with stroke (46 patients) and found that the patients with Covid tended to be younger (average age 63) versus non-Covid stroke patients (average age 70). Strokes among the Covid patients were more severe (based on a stroke scale) and these patients were more likely to be dead at hospital discharge (63.6% vs. 9.3%).

Another study, from Hong Kong, reported delays in the time from stroke onset to hospital arrival. Between January 23 and March 24, the onset-to-arrival time in Queen Mary Hospital was about an hour longer in 2020 compared with 2019 (154 minutes vs 95 minutes).

A study from China found that in February 2020, hospital admissions related to stroke dropped 40%, compared to the same time period in 2019.

A fourth study, from France, found that between February 15 and March 30, there was a 21% decrease (844 in 2019 vs 668 in 2020) in overall volume of ischemic patients receiving mechanical thrombectomy during the pandemic compared to 2019. Additionally, there was an increase in the amount of time from imaging to treatment overall — 145 minutes in 2020 vs 126 minutes in 2019; this increased by 30 minutes in patients transferred to other facilities for treatment after imaging.

Source: American Heart Association