1 in 50 COVID Patients in ICU Will Develop a Stroke

Among COVID-19 patients in intensive care units (ICUs), 2% suffer a stroke, a new study finds.

Of the two types of stroke, hemorrhagic stroke, which is caused by bleeding in the brain, was linked to a higher risk of death than ischemic stroke, which is caused by a blood clot in the brain. Data on just under 2,700 patients was used for the study.

“For people with severe COVID-19 requiring intensive care, our large study found that stroke was not common, and it was infrequently the cause of death,” said researcher Dr. Jonathon Fanning, from the University of Queensland in Brisbane, Australia.

“While the proportion of those with stroke may not be as high as initially thought, the severity of the pandemic means the absolute overall number of patients around the world and the ongoing implications will be a major public health crisis,” he added.

Despite the low risk of stroke tied to COVID, a New York stroke specialist who reviewed the findings noted that SARS-CoV-2 can cause “significant neurologic problems.”

Dr. Andrew Rogove, medical director of stroke services at South Shore University Hospital in Bay Shore, N.Y., said a review of more patients is needed to gauge the true effect of COVID infections on stroke risk.

“It will be interesting to see how these data are affected by a larger sample size and whether stroke rates decrease as we learn more about COVID infection and how to better treat and prevent neurologic complications of this disease,” he said.

For the study, Fanning’s team collected information on nearly 2,700 COVID patients hospitalized in ICUs in 52 countries between Jan. 1 and Dec. 21, 2020. In all, 59 patients had a stroke in the ICU.

Of those, 19 (32%) had an ischemic stroke; 27 (46%) had a hemorrhagic, or bleeding, stroke; and 13 (22%) had an undetermined type of stroke, the researchers found.

People who had a bleeding stroke had up to a five times higher risk of death than patients who didn’t have a stroke. People who had an ischemic stroke were at no increased risk of death.

Of patients with a bleeding stroke, 72% died, but stroke was the primary cause of death in only 15%. Multi-organ failure was the leading cause of death, the researchers found.

Dr. Larry Goldstein, chairman of the Department of Neurology at the University of Kentucky, noted another study yielded similar findings.

That analysis of data from 21,000 COVID patients at 160 hospitals found that 1.4% had a stroke (53% from a clot, 15% from bleeding into the brain and 11% from bleeding around the brain).

Those who had a stroke were more like to be older men, Goldstein said.

“Unlike the present study, those who had a stroke due to a blood clot had twice the risk of death during the hospitalization,” he said. “Data related to bleeding strokes was not presented.”

The new study was presented Thursday at a virtual meeting of the American Academy of Neurology. Findings presented at meetings are considered preliminary until published in a peer-reviewed journal.

More information

For more on stroke, head to the American Stroke Association.

SOURCES: Jonathon Fanning, PhD, senior lecturer, University of Queensland, Brisbane, Australia; Andrew Rogove, MD, PhD, medical director, stroke services, South Shore University Hospital, Bay Shore, N.Y.; Larry Goldstein, MD, chairman, Department of Neurology, University of Kentucky, and co-director, Kentucky Neuroscience Institute, Lexington; American Academy of Neurology, online meeting, April 15, 2021

Source: HealthDay