PURPOSE: Acute ischemic stroke may occur in patients with coronavirus disease 2019 (COVID-19), but risk factors, in-hospital events, and outcomes are not well studied in large cohorts . We identified risk factors, comorbidities, and outcomes in patients with COVID-19 with or without acute ischemic stroke and compared with patients without COVID-19 and acute ischemic stroke .
METHODS: We analyzed the data from 54 health care facilities using the Cerner deidentified COVID-19 dataset . The dataset included patients with an emergency department or inpatient encounter with discharge diagnoses codes that could be associated to suspicion of or exposure to COVID-19 or confirmed COVID-19 .
RESULTS: A total of 103 (1.3 %) patients developed acute ischemic stroke among 8163 patients with COVID-19 . Among all patients with COVID-19, the proportion of patients with hypertension, diabetes, hyperlipidemia, atrial fibrillation, and congestive heart failure was significantly higher among those with acute ischemic stroke . Acute ischemic stroke was associated with discharge to destination other than home or death (relative risk , 2.1 [95% CI , 1.6-2.4]; P <0.0001) after adjusting for potential confounders . A total of 199 (1.0 %) patients developed acute ischemic stroke among 19 513 patients without COVID-19 . Among all ischemic stroke patients, COVID-19 was associated with discharge to destination other than home or death (relative risk , 1.2 [95% CI , 1.0-1.3]; P=0.03) after adjusting for potential confounders .
CONCLUSIONS: Acute ischemic stroke was infrequent in patients with COVID-19 and usually occurs in the presence of other cardiovascular risk factors . The risk of discharge to destination other than home or death increased 2-fold with occurrence of acute ischemic stroke in patients with COVID-19.