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Clinical course and outcome of stroke patients at a tertiary health care center during SARS-COV-2 pandemic in North India: A single-center study
Virendra Atam1, Satish Kumar1, Kumar Rahul2, Bhupendra Kumar2, Harish Gupta3, Satyendra Kumar Sonkar1, Munna Lal Patel1, Amit Kumar1, Anshu Singh4, Ambuj Yadav1
1 Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
2 Department of Cardiovascular and Thoracic Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
3 Department of Internal Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
4 Department of Plastic Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
Correspondence Address:
Kumar Rahul,
Department of Cardiovascular and Thoracic Surgery, King George's Medical University, Lucknow, Uttar Pradesh
India
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/jascp.jascp_29_22
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Background: SARS-COV-2 is primarily a respiratory illness. However, beyond respiratory illness and associated acute and long-term medical complications, it manifests as stroke, including acute ischemic stroke and hemorrhagic stroke. Clinical evidence reported the occurrence of both venous and arterial thromboembolic complications in SARS-COV-2 positive patients due to hypercoagulable state, hyperinflammatory response, cardiomyopathy, and endothelial inflammation. Materials and Methods: This is a retrospective, single-center cohort study, which includes confirmed SARS-COV-2-positive patients hospitalized between March 2021 and February 2022. Clinical and biochemical data were analyzed. Noncontrast computed tomography of the brain was performed to assess the area and type of stroke. Results: Among all the included 703 patients with SARS-COV-2, 42 patients developed stroke. SARS-COV-2 patients who developed stroke were older and had multiple comorbidities. Patients had higher quick sequential organ failure assessment (qSOFA) score on hospitalization (P < 0.05), higher in-hospital mortality, and had poor clinical outcomes (P < 0.0001). In multivariate regression analysis, there were higher odds of in-hospital mortality linked with higher qSOFA scores (odds ratio 4.47, 95% confidence interval 1.21–16.5; P = 0.025). SARS-COV-2 patients developing stroke had high total leukocyte counts, high neutrophil counts, low platelet counts, low lymphocyte counts, raised C-reactive protein, raised ferritin levels, raised interleukin-6, raised fibrinogen, and D-dimer as compared to those without stroke. Conclusion: Patients with SARS-COV-2 who developed stroke had more severe clinical symptoms, poor clinical outcomes, and higher in-hospital mortality rates compared to those without stroke.
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