Clinical features and mortality risk in Acute Ischemic Stroke with COVID-19: a multicenter-based comparative analysis of elderly and younger populations in Saudi Arabia.

Ischemic stroke, a major cause of morbidity and mortality in elderly individuals, has increased with coronavirus disease 2019 (COVID-19). This study compared the demographic and clinical features of ischemic stroke patients with COVID-19 aged < 65 years and those aged ≥ 65 years and focused on the impact of comorbidities on mortality. A total of 111 ischemic stroke patients with COVID-19 were investigated. The participants were divided into two age groups: those < 65 years and those ≥ 65 years. Demographic and clinical data were analyzed, and outcomes were compared between age groups. Multivariate logistic regression analysis was used to determine the key factors associated with mortality. Most patients were male (62.2%), with a greater proportion of patients aged ≥ 65 years (70.6% vs. 48.9%, p = 0.021). Hypertension (67.6%), diabetes mellitus (62.2%), and dyslipidemia (34.2%) were prevalent, with dyslipidemia being more common in those aged ≥ 65 years (42.7% vs. 20.9%, p = 0.019). Overall mortality was 23.4%, with no significant difference according to age group (p = 0.341). Multivariate analysis revealed that a 5-year increase in age was a significant predictor of mortality, with an aOR of 1.43 (95% CI: 1.11-1.85), p = 0.006. Males were associated with lower odds of mortality, with an aOR of 0.19 (0.04-0.81), p = 0.025. Dementia and pneumonia were significant predictors of mortality, with aORs of 15.34 (95% CI: 2.72-86.59), p = 0.002 and 11.92 (95% CI: 2.43-58.43), p = 0.002, respectively. These findings highlight age, sex, and specific comorbidities as critical determinants of mortality in this population, emphasizing the need for tailored interventions to address respiratory and cognitive complications alongside traditional risk factors.