Khorvash Fariborz, Najafi Mohammad Amin, Kheradmand Mohsen, Saadatnia Mohammad, Chegini Rojin, Najafi Farideh
Department of Neurology, Al Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Metabolic Liver Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2022 Apr 15;27:31. doi: 10.4103/jrms.jrms_255_21. eCollection 2022.
Neurological manifestations of coronavirus disease 2019 (COVID-19) have been highlighted. COVID-19 potentially increases the risk of thromboembolism. We aimed to compare patients with COVID-19 with and without new-onset acute ischemic stroke (AIS).
In this single-center retrospective case-control study, demographics, clinical characteristics, laboratory findings, and clinical outcomes were compared between 51 patients with both COVID-19 and AIS (group A) and 160 patients with COVID-19 and without AIS (group B).
Patients in group A were significantly older, more likely to present with critical COVID-19 ( = 0.004), had higher rates of admission in the intensive care unit ( < 0.001), more duration of hospitalization ( < 0.001), and higher in-hospital mortality ( < 0.001). At the time of hospitalization, O saturation ( = 0.011), PH ( = 0.04), and HCO3 ( = 0.005) were lower in group A. White blood cell count ( = 0.002), neutrophil count ( < 0.001), neutrophil-lymphocyte ratio ( = 0.001), D-Dimer ( < 0.001), blood urea nitrogen (BUN) ( < 0.001), and BUN/Cr ratio ( < 0.001) were significantly higher in patients with AIS.
Stroke in COVID-19 is multifactorial. In addition to conventional risk factors of ischemic stroke (age and cardiovascular risk factors), we found that patients with more severe COVID-19 are more prone to ischemic stroke. Furthermore, leukocyte count, neutrophil count, neutrophil-lymphocyte ratio, D-Dimer, BUN, and BUN/Cr ratio were higher in patients with AIS following COVID-19 infection.
2019冠状病毒病（COVID-19）的神经学表现已受到关注。COVID-19可能会增加血栓栓塞的风险。我们旨在比较患有和未患有新发急性缺血性卒中（AIS）的COVID-19患者。
在这项单中心回顾性病例对照研究中，对51例同时患有COVID-19和AIS的患者（A组）和160例患有COVID-19但未患AIS的患者（B组）的人口统计学、临床特征、实验室检查结果及临床结局进行了比较。
A组患者年龄显著更大，更有可能表现为重症COVID-19（P = 0.004），入住重症监护病房的比例更高（P < 0.001），住院时间更长（P < 0.001），院内死亡率更高（P < 0.001）。住院时，A组的血氧饱和度（P = 0.011）、pH值（P = 0.04）和碳酸氢根（P = 0.005）较低。AIS患者的白细胞计数（P = 0.002）、中性粒细胞计数（P < 0.001）、中性粒细胞与淋巴细胞比值（P = 0.001）、D-二聚体（P < 0.001）、血尿素氮（BUN）（P < 0.001）及BUN/肌酐比值（P < 0.001）显著更高。
COVID-19相关性卒中是多因素导致的。除了缺血性卒中的传统危险因素（年龄和心血管危险因素）外，我们发现病情更严重的COVID-19患者更容易发生缺血性卒中。此外感染COVID-19后发生AIS的患者白细胞计数、中性粒细胞计数、中性粒细胞与淋巴细胞比值、D-二聚体、BUN及BUN/肌酐比值更高。
