Postacute coronavirus disease 2019 acute ischemic stroke profile and outcome among egyptians

Abstract

Background Coronavirus disease 2019 (COVID-19) is the most dangerous global health crisis since the era of the influenza pandemic 1918. Aim The aim of this work was to study the characteristics and short-term outcomes of acute ischemic stroke (AIS) in patients recovered from COVID-19 among a sample of the Egyptian population. Patients and methods The cross-sectional prospective study included 108 patients: 58 patients with AIS documented by brain cranial computed tomography and/or brain magnetic resonance imaging (MRI) who recovered from COVID-19 infection for at least 3 months and another 50 patients (control) without history of COVID-19 infection. Neurological examination including Glasgow Coma Score, National Institute of Health Stroke Scale (NIHSS) and Oxfordshire Community Stroke Project Classification classification as well as TOAST classification done for all patients. Results Regarding modified ranking scale (MRS), a mild increase in the patient group is detected but without significant difference between both groups. Regarding mortality, it was significantly higher in the patient group than in the control group. The relation between presenting symptoms of COVID-19, severity of previous COVID-19, and type of previous infection with NIHSS and MRS of patients, revealed that respiratory manifestations associated with higher NIHSS and MRS. Relation between lymphopenia, erythrocyte sedimentation rate, NIHSS, and MRS revealed inverse relationship between lymphocytic count and NIHSS and MRS, while positive relationship was detected between erythrocyte sedimentation rate, NIHSS, and MRS. Conclusion Postacute COVID-19 AIS has characteristic features regarding risk factors, clinical presentation, investigations, etiology, and outcome. The risk of AIS must be considered when the patient has beedn previously infected with COVID-19.