Comparative Functional Outcomes for Ischemic Stroke Patients with and without COVID-19

Document Type

Article

Publication Date

2025

Abstract

Background: COVID-19, primarily a respiratory illness caused by SARS-CoV-2, is associated with vascular complications like ischemia due to endothelial injury, hypercoagulability, and inflammation. This study examines how COVID-19 affects functional outcomes of ischemic stroke patients. Methods: Ischemic stroke patients admitted to our Joint Commission-certified primary stroke center were retrospectively analyzed from March 1, 2020, to March 1, 2022. A subgroup analysis was conducted for patients during the vaccination period (April 14, 2021, to March 1, 2022). Patients were included if they were ≥18 years old and had a stroke on admission or during hospitalization. Univariate and multivariable analyses were used, with a significance threshold of p< 0.05. Results: Out of 1,171 patients, those who tested positive for COVID-19 had significantly worse outcomes. Demographics, clinical data, and outcomes are found in Table 1. COVID-19 Positive patients experienced fewer days between stroke and death (4 days vs. 25 days, p=0.047), higher modified Rankin Scale (mRS) scores at discharge (3 vs. 1, p=0.001), and increased rates of altered consciousness (41.46% vs. 21.86%, p=0.03). In the vaccination period subgroup, COVID-positive patients had fewer days from stroke to death (4 days vs. 42 days, p=0.047), worse mRS scores (3 vs. 1, p=0.009), longer delays in discharge placement (0 vs. 1 day, p=0.020), and higher rates of altered consciousness (57.89% vs. 23.71%, p=0.001). Additionally, COVID-negative patients were more likely to be discharged home (49.52% vs. 36.84%, p=0.021). Multivariable analysis identified higher NIHSS at admission (OR: 1.028 [1.003-1.053], p=0.027), older age (OR: 1.027 [1.011-1.045], p=0.001), and a history of diabetes (OR: 1.596 [1.056-2.413], p=0.027) as increased mortality risks. Conclusion: COVID-19 is associated with worse recovery outcomes and discharge delays for ischemic stroke patients compared to those without COVID-19. Further research is needed to explore these differences and their implications for stroke management amid the ongoing global health crisis.

Comments

This abstract was published in Stroke, Volume 56, Supplement 1.

The published version is available at https://doi.org/10.1161/str.56.suppl_1.WP209.

Copyright © 2025 .

Publication Title

Stroke

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