Lin Chen, Arevalo Yurany A, Nanavati Hely D, Lin Diana M
Department of Neurology, The University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
Brain Behav Immun Health. 2020 Oct;8:100137. doi: 10.1016/j.bbih.2020.100137. Epub 2020 Sep 1.
To describe the difference in clinical presentation, including race, of ischemic stroke between patients with and without novel coronavirus disease 2019 (COVID-19), and the association of inflammatory response with stroke severity.
This is a retrospective, observational, cross-sectional study of patients (n = 60) admitted with ischemic stroke between late March and early May 2020. All patients were tested for COVID-19 during admission. Demographic, clinical, and laboratory data was collected through electronic medical record review. Descriptive statistics was performed to observe the differences between stroke patients with and without COVID-19.
60 hospitalized patients with acute ischemic stroke were included in the analysis. Nine were positive for COVID-19. African-Americans comprised of 55.6% of those that had COVID-19 and stroke and 37.7% of those with only stroke. Stroke patients with COVID-19 had a significantly higher NIHSS [18.4 (8.8)] and neutrophil-to-lymphocyte ratio (NLR) [7.3 (4.2) vs 3.8 (2.8); = 0.0137] than those without. Those with COVID-19 also had a significantly higher mortality rate (44.4% vs. 7.6%; p < 0.001).
We observed a cohort of patients, including a large proportion of African-Americans, who developed ischemic stroke with or without COVID-19. An exaggerated inflammatory response, as indicated by NLR, likely plays a role in stroke severity among COVID-19 patients that concurrently develop ischemic stroke.
描述2019年新型冠状病毒病（COVID-19）患者与非COVID-19患者缺血性卒中临床表现的差异，包括种族差异，以及炎症反应与卒中严重程度的关联。
这是一项对2020年3月下旬至5月初因缺血性卒中入院的患者（n = 60）进行的回顾性、观察性横断面研究。所有患者入院时均接受了COVID-19检测。通过电子病历回顾收集人口统计学、临床和实验室数据。进行描述性统计以观察COVID-19阳性和阴性卒中患者之间的差异。
60例急性缺血性卒中住院患者纳入分析。9例COVID-19检测呈阳性。非裔美国人在患有COVID-19和卒中的患者中占55.6%，在仅患有卒中的患者中占37.7%。患有COVID-19的卒中患者美国国立卫生研究院卒中量表（NIHSS）评分[18.4（8.8）]和中性粒细胞与淋巴细胞比值（NLR）[7.3（4.2） vs 3.8（2.8）；P = 0.0137]显著高于未感染COVID-19的患者。患有COVID-19的患者死亡率也显著更高（44.4% vs. 7.6%；P < 0.001）。
我们观察到一组患者，包括很大比例的非裔美国人，他们无论是否感染COVID-19均发生了缺血性卒中。如NLR所示，过度的炎症反应可能在同时发生缺血性卒中的COVID-19患者的卒中严重程度中起作用。
