Incidence and Laboratory Predictors of Acute Ischemic Stroke in COVID-19: A Cross-Sectional Study

Document Type : Original Article

Authors

Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran

Abstract

Background: The possibility of central nervous system (CNS) involvement following Coronavirus Disease 2019 (COVID-19) is rare. Laboratory tests may play a predictive role in the occurrence of stroke.
 
Objective: The objectives of this study were twofold: first, to investigate the incidence of acute stroke, and second, to examine the role of laboratory tests in predicting the occurrence of these events following infection.
 
Methods: This cross-sectional study was conducted over one year. The inclusion criteria were as follows: patients over 18 years of age with a positive multiple polymerase chain reaction (RT-PCR) test result or typical lung CT findings of confirmed cases of pneumonia due to COVID-19 and who had undergone a brain CT scan due to suspicion of brain damage. The patients were divided into two groups, with and without brain damage, and compared with each other. The chi-square test was employed to evaluate the correlation between the qualitative variables, while the Mann-Whitney U test and the Student's t-test were applied to analyze the quantitative variables. Subsequently, logistic regression analysis was conducted to examine the association between patient outcomes and the pertinent variables. A p-value of less than 0.05 was established as indicative of statistical significance. Data analysis was conducted using SPSS.
 
Results: Among the 6604 patients, 98 underwent brain CT scans, of which 9.18% had stroke. Notably, 0.55% of all patients had acute ischemic stroke, a proportion that was significantly higher in women than in men. A statistically significant difference was observed in blood glucose (BG) and activated partial thromboplastin time (aPTT) levels among patients with ischemic stroke compared to those without stroke (p < 0.05). In both univariate and multivariate analyses with logistic regression, the three variables gender, blood glucose, and aPTT were significantly associated with the incidence of ischemic stroke. The Area Under the Curve (AUC) values for BG and aPTT were determined to be 0.66 and 0.67, respectively.
 
Conclusion: The incidence of acute stroke following COVID-19 infection is not common. In female patients, decreased blood glucose and decreased aPTT were associated with an increased incidence of ischemic stroke following infection.

Keywords

Acknowledgements: This study was supported by the Clinical Research Center of Afzalipour Academic Hospital, Kerman University of Medical Science, Kerman, Iran.

 

Availability of data and materials: The dataset presented in the study is available on request from the corresponding author during submission or after its publication.

 

Conflicts of interests: The authors declared no potential conflicts of interest.

 

Consent for publication: Not applicable.

 

Ethics approval and consent to participate: The Kerman University of Medical Sciences ethics committee approved the study protocol with the number of IR.KMU.AH.REC.1403.040, which complies with the declaration of Helsinki.

 

Financial disclosure: No funding.

 

Author contributions: Study concept, design, and supervision: M.T, S.AS, M.A. Acquisition of data: M.A. Analysis and interpretation of data: M.T. Drafting of the manuscript, technical and material support: M.T, S.AS, M.A.

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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