The clinical characteristics and prognosis of COVID-19 patients with cerebral stroke：a retrospective cohort study

Abstract Objective: To explore the clinical characteristics and prognosis of COVID-19 patients with cerebral stroke.Methods: In this retrospective study, 2474 patients with COVID-19 were admitted and treated in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology in Wuhan from February 10, 2020, to March 24, 2020. Data on the clinical characteristics, laboratory parameters and prognosis of COVID-19 patients with or without cerebral stroke were collected and comparatively analyzed.Results: Of 2474 COVID-19 patients (61.0±15.7 years; 1235 males [49.9%]), 113 (4.7%) patients had cerebral stroke, and 25 (1.0%) patients had a new onset of stroke. Eighty-eight (77.9%) patients in the previous stroke group had cerebral ischemia, while 25 (22.1%) patients in the new-onset stroke group had cerebral ischemia. Most COVID-19 patients with stroke were elderly with more complicated disorders, such as hypertension, diabetes and heart diseases. Laboratory examinations showed a hypercoagulation status and elevated serum parameters such as IL-6, cTnI, NT pro-BNP and BUN. Of note, stroke patients revealed a nearly double mortality (12.4% vs 6.9%) to that of patients without stroke. Additionally, age (≥60 years), fingertip oxygen saturation (<93%) and consciousness disorder were independent predictors for new cerebral stroke in COVID-19 patients. Interpretation: The high risk of new-onset stroke in COVID-19 patients was older age combined with fingertip oxygen saturation (<93%) and consciousness disorder. These patients are more vulnerable to multiple organ dysfunction and an overactivated inflammatory response, in turn leading to a deteriorated outcome and mortality.