Stroke Rate in COVID-19 May Be Lower Than Previously Suggested but With More Severe Symptoms

A new analysis finds a smaller proportion of individuals than previously reported had a stroke as a result of COVID-19. However, strokes linked to the virus, SARS-CoV-2, appear to be more severe.

In a NYU Grossman School of Medicine-led study, researchers found that fewer than 1% of hospitalized individuals who tested positive during 1 month for COVID-19 also had a stroke. This contrasts with the rates reported recently in small studies in China and Italy, which ranged from 2% to 5%. 
However, the current investigation also revealed that people with both conditions were younger than is typical for stroke, had worse symptoms, and were at least 7 times more likely to die than individuals who had a stroke but were not infected with SARS-CoV-2. 

"Our study suggests that stroke is an uncommon yet important complication of coronavirus given that these strokes are more severe when compared with strokes occurring in patients who tested negative for the virus," says study lead author Shadi Yaghi, MD, an assistant professor in the Department of Neurology at NYU Langone Health and director of clinical vascular neurology research.

Yaghi cautions that the public should always take stroke symptoms seriously. Anyone who experiences symptoms of trouble walking or speaking, or sudden paralysis of the face or limbs, should seek immediate emergency medical care regardless of concerns about exposure to SARS-CoV-2. 

For the investigation, the researchers used medical records to identify 3,556 individuals diagnosed with COVID-19. Of this group, 32 individuals had strokes at NYU Langone hospitals in New York City and Long Island between March 15 and April 19. Strokes in individuals with COVID-19 had more severe symptoms than their counterpartsthose seen in comparable cases during the previous year without the virusout COVID-19. In fact, during the study period, 63% died, compared with just 9% for those without the virus and 5% of individuals who had a stroke in the previous year before the pandemic.

The results also add to other early research suggesting that strokes among individuals with COVID-19 form differently than the majority of strokes. Among participants of study with COVID-19, at least 56% of the strokes appeared to arise from increased blood-clotting throughout the body. This finding may offer a clue to how physicians can better treat stroke occurring in individuals who have the virus, the study authors say. 

The new study, publishing May 20 in the journal Stroke, is the largest of its kind among people with COVID-19 and stroke individuals and adds valuable insight into the poorly understood complications of COVID-19.