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Research Article
Aline Mendes
University Hospital of Geneva
Corresponding Author
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Background: Stroke in the course of coronavirus disease (COVID-19) was associated with higher severity of respiratory symptoms and mortality, but little knowledge exists on older populations. We aimed to investigate the incidence, characteristics, and prognosis of acute stroke in old patients hospitalized with COVID-19.
Methods: Monocentric retrospective study of 265 older patients hospitalized with COVID-19 in geriatric wards, 11 of which having presented a stroke episode during hospitalization. Mortality rates and two-group comparisons (stroke vs non-stroke patients) were calculated and significant variables added in logistic regression models to investigate stroke risk factors.
Results: Combined ischemic and hemorrhagic stroke incidence was 4.15%. 72.7% of events occurred during acute care. Strokes presented with altered state of consciousness and/or delirium in 81.8%, followed by a focal neurological deficit in 45.5%. Ischemic stroke was more frequently unilateral (88.8%) and localized in the middle cerebral artery territory (55.5%). Smoking and a history of previous stroke increased by more than seven (OR 7.44; 95% CI 1.75-31.64; p=0.007) and five times (OR 5.19; 95% CI 1.50-17.92; p=0.009), respectively, the risk of stroke. Each additional point in body mass index (BMI) reduced the risk of stroke by 14% (OR 0.86; 95% CI 0.74-0.98; p=0.03). In-hospital mortality (32.1% vs. 27.3%; p>0.999) and institutionalization at discharge (36.4% vs. 21.1%; p=0.258) were similar between patients with and without stroke.
Conclusion: Incident stroke complicating COVID-19 in old patients was associated with active smoking, previous history of stroke, and low BMI. Acute stroke did not influence early mortality or institutionalization rate at discharge.
Keywords
COVID-19, stroke, cerebrovascular, ischemic stroke, hemorrhagic stroke
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CURRENT STATUS: Published
View the published article at BMC Geriatrics.
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Posted 02 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 09 Dec, 2020
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Received 04 Dec, 2020
Reviewers agreed
On 01 Dec, 2020
Reviewers agreed
On 27 Nov, 2020
Reviewers invited
Invitations sent on 26 Nov, 2020
Editor assigned
On 26 Nov, 2020
Editor invited
On 26 Nov, 2020
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Subject Areas
Geriatrics & Gerontology
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A new preprint design is coming!
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See the published version of this preprint at BMC Geriatrics.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Aline Mendes
University Hospital of Geneva
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Geriatrics.
Version 1
Posted 02 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 09 Dec, 2020
Reviews received
Received 04 Dec, 2020
Reviewers agreed
On 01 Dec, 2020
Reviewers agreed
On 27 Nov, 2020
Reviewers invited
Invitations sent on 26 Nov, 2020
Editor assigned
On 26 Nov, 2020
Editor invited
On 26 Nov, 2020
Submission checks complete
On 26 Nov, 2020
First submitted
On 17 Nov, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Geriatrics & Gerontology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Geriatrics.
Background: Stroke in the course of coronavirus disease (COVID-19) was associated with higher severity of respiratory symptoms and mortality, but little knowledge exists on older populations. We aimed to investigate the incidence, characteristics, and prognosis of acute stroke in old patients hospitalized with COVID-19.
Methods: Monocentric retrospective study of 265 older patients hospitalized with COVID-19 in geriatric wards, 11 of which having presented a stroke episode during hospitalization. Mortality rates and two-group comparisons (stroke vs non-stroke patients) were calculated and significant variables added in logistic regression models to investigate stroke risk factors.
Results: Combined ischemic and hemorrhagic stroke incidence was 4.15%. 72.7% of events occurred during acute care. Strokes presented with altered state of consciousness and/or delirium in 81.8%, followed by a focal neurological deficit in 45.5%. Ischemic stroke was more frequently unilateral (88.8%) and localized in the middle cerebral artery territory (55.5%). Smoking and a history of previous stroke increased by more than seven (OR 7.44; 95% CI 1.75-31.64; p=0.007) and five times (OR 5.19; 95% CI 1.50-17.92; p=0.009), respectively, the risk of stroke. Each additional point in body mass index (BMI) reduced the risk of stroke by 14% (OR 0.86; 95% CI 0.74-0.98; p=0.03). In-hospital mortality (32.1% vs. 27.3%; p>0.999) and institutionalization at discharge (36.4% vs. 21.1%; p=0.258) were similar between patients with and without stroke.
Conclusion: Incident stroke complicating COVID-19 in old patients was associated with active smoking, previous history of stroke, and low BMI. Acute stroke did not influence early mortality or institutionalization rate at discharge.
Figure 1
Figure 1
Figure 2
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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