Clinical Characteristics of the Course of Ischemic Stroke Associated With Covid-19

Purpose: Аn analysis of the clinical and laboratory parameters of ischemic stroke (IS) associated with the new coronavirus infection COVID-19 (NCVI). Materials and methods: the study provided a comparative analysis of 52 IS cases in combination with NCVI (main group) and 253 IS cases without NCVI (comparison group). All the patients were analyzed in terms of the IS severity according to the NIHSS scale; stroke subtypes according to the TOAST classification; locations of the affected vascular territories, and clinical outcomes. We also evaluated hemostasis parameters, inflammatory markers and D-dimer levels in 149 patients. Results: it was revealed that in the IS group with NCVI compared with the group without NCVI, the stroke severity according to the NIHSS scale was higher at the moment of admission (8.0 [2.0; 14.0] points versus 5.0 [2.0; 11.0] points; p = 0.049); lacunar stroke subtype was diagnosed less often (p = 0.03; OR = 0.23; 95% CI 0.05-0.97); disease progression was observed more frequently (p = 0.04; OR = 2.66; 95% CI 1.01-6.95); and the mortality rate was significantly higher (p < 0.001; OR= 9.04; 95% CI 4.12-19.82). Among the inflammatory markers, higher ferritin and IL-6 levels were recorded in the IS group in combination with NCVI compared to the IS group without NCVI (p = 0.002 and p = 0.017). Conclusions: ischemic stroke associated with a new coronavirus infection is characterized by a more frequent disease progression, more frequent large ischemia, and high mortality rate. An increased level of markers indicates the effect of systemic inflammatory response on the ischemic stroke with NCVI.