- Stroke is much more common among patients with COVID-19 than among patients with influenza.
- Mortality is also higher for patients with COVID-19 who experience stroke vs those who do not.
Why this matters
- Providers should be vigilant for stroke in patients with COVID-19.
- COVID-19 is often incorrectly compared with influenza in its severity.
- Acute ischemic stroke rates (95% CIs) with:
- COVID-19: 1.6% (1.1%-2.3%).
- Influenza: 0.2% (0.0%-0.6%).
- Mortality among patients with COVID-19 with vs without stroke: 32% vs 14% (P=.003).
- aOR (95% CI) for stroke, COVID-19 vs influenza:
- Adjusted for age, sex, and race: 7.6 (2.3-25.2).
- Additionally adjusted for vascular risk factors and ICU admissions: 4.6 (1.4-15.7).
- A 2-hospital retrospective cohort study in New York City.
- Authors assessed outcomes among adults with emergency department (ED) visits or hospitalizations related to laboratory-confirmed coronavirus infection between March 4, 2020 and May 2, 2020 (n=1916).
- Comparators: adults with ED visits or hospitalizations related to laboratory-confirmed influenza, January 2016-May 2018 (n=1486).
- Outcome: acute ischemic stroke.
- Funding: NIH; New York-Presbyterian Hospital; Weill Cornell Medical College.
- Some cases of stroke may have been missed because of death or inability to undergo CT scan.
- Comparative illness severity of patients with COVID-19 vs influenza is unclear.