Perelman School of Medicine at the University of Pennsylvania

Hospitalized COVID-19 Patients Have Low Risk of Stroke

Penn study suggests ischemic stroke likely due to existing risk factors, rather than COVID-19

Newswise — PHILADELPHIA—While initial reports suggested a significant risk of stroke in patients hospitalized with COVID-19, a new paper published in Stroke from Penn Medicine shows a low risk of stroke in patients hospitalized for COVID-19. Notably, the majority of afflicted patients had existing risk factors, such as high blood pressure and diabetes. These findings provide more clarity about the role COVID-19 plays in causing stroke in a diverse population of the United States.

“While there was initial concern for a high number of strokes related to COVID-19, that has not been born out. Importantly, while the risk for stroke in COVID-19 patients is low, it’s mostly tied to pre-existing conditions—so physicians who do see stroke in hospitalized COVID-19 patients must understand the virus is not the only factor, and it’s necessary to follow through with normal diagnostic testing,” said Brett Cucchiara, MD, an associate professor of Neurology in the Perelman School of Medicine at the University of Pennsylvania, and senior author of the paper. “However, there are still many unknowns and we need to continue investigating the linkage between stroke and COVID-19, particularly considering the racial disparities surrounding the disease.”

To evaluate the risk and incidence of stroke in COVID-19 hospitalized patients, researchers analyzed data from 844 COVID-19 patients admitted to the Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center, and Pennsylvania Hospital between March and May. The team also analyzed the data for cases of intracranial hemorrhage (bleeding in the brain).

Researchers found that 2.4 percent of patients hospitalized for COVID-19 had an ischemic stroke—the most common type of stroke, typically caused by a blood clot in the brain. Importantly, the majority of these stroke patients had existing risk factors, such as high blood pressure (95 percent) and a history of diabetes (60 percent), and traditional stroke mechanisms, such as heart failure. Additionally, over one-third had a history of a previous stroke.

Researchers say the results suggest that these cerebrovascular events in hospitalized COVID-19 patients are likely tied to existing conditions, and not the sole consequence of the virus. However, other factors could be at play and require continued research. While the precise mechanisms linking cerebrovascular events to COVID-19 remain uncertain at this time, it has recently been reported that the viral infection, SARS-CoV-2, causes inflammation and a hypercoagulable state (excessive blood clotting)—both could be potential mechanisms leading to stroke.

The population of patients for the study was unique as well, with a more diverse cohort compared to previous reported studies. Black patients accounted for 68 percent of the study population and of the hospitalized patients who had a stroke, 80 percent were Black.

“This aligns with the data we’re seeing on the racial disparities of the virus across our country,” said Cucchiara. “We worry that this could further indicate the higher risks associated with COVID-19 in Black populations, much more so than white. So far, we don’t understand the disproportionate effect we’re seeing, but the disparities in infection rates and outcomes is incredibly important to figure out and address.”

In addition to the incidents of stroke, the research team found that 0.9 percent of hospitalized COVID-19 patients had intracranial hemorrhage. While the rate of stroke in hospitalized COVID-19 patients is comparable to studies in Wuhan, China and Italy, the rate of intracranial hemorrhage, which has not previously been reported, is higher than investigators expected. The authors note this could be tied to the increasing use of anticoagulant therapy (blood thinners) in COVID-19 patients, and requires additional exploration.

Notably, there was a relatively long duration of time from initial COVID-19 symptoms to diagnosis of ischemic stroke, at an average of 21 days. This finding is consistent with increasing evidence of a hypercoagulable state which evolves over the initial weeks of the disease in many patients, and requires further study, the authors note.   

The cohort of patients had an average age of 59 years, and the mean age of the ischemic stroke patients was 64 years, with only one patient under age 50. This finding differs significantly from early reports that raised concern there might be a high rate of stroke among younger patients.

Additional Penn authors include Aaron Rothstein, Olivia Oldridge, Hannah Schwennesen, and David Do.

###

Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation’s first medical school) and the University of Pennsylvania Health System, which together form a $8.6 billion enterprise.

The Perelman School of Medicine has been ranked among the top medical schools in the United States for more than 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $494 million awarded in the 2019 fiscal year.

The University of Pennsylvania Health System’s patient care facilities include: the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center—which are recognized as one of the nation’s top “Honor Roll” hospitals by U.S. News & World Report—Chester County Hospital; Lancaster General Health; Penn Medicine Princeton Health; and Pennsylvania Hospital, the nation’s first hospital, founded in 1751. Additional facilities and enterprises include Good Shepherd Penn Partners, Penn Medicine at Home, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.

Penn Medicine is powered by a talented and dedicated workforce of more than 43,900 people. The organization also has alliances with top community health systems across both Southeastern Pennsylvania and Southern New Jersey, creating more options for patients no matter where they live.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2019, Penn Medicine provided more than $583 million to benefit our community.

 

SEE ORIGINAL STUDY




Filters close

Showing results

110 of 4146
Newswise: Long-Term Impacts of COVID-19: Your Mental Health
Released: 25-Nov-2020 2:15 PM EST
Long-Term Impacts of COVID-19: Your Mental Health
Cedars-Sinai

The COVID-19 pandemic has shaped more than half a year of our lives, canceling plans, upending livelihoods and causing feelings of grief, stress and anxiety. And Cedars-Sinai mental health experts say the pandemic could be shaping our mental health well into the future.

Released: 25-Nov-2020 12:45 PM EST
SARS-CoV-2 mutations do not appear to increase transmissibility
University College London

None of the mutations currently documented in the SARS-CoV-2 virus appear to increase its transmissibility in humans, according to a study led by UCL researchers.

Newswise: COVID-19 vaccine candidate tested preclinically at UAB nears first clinical test in people
Released: 25-Nov-2020 11:05 AM EST
COVID-19 vaccine candidate tested preclinically at UAB nears first clinical test in people
University of Alabama at Birmingham

Maryland-based Altimmune Inc., a clinical stage biopharmaceutical company, has submitted an Investigational New Drug, or IND, application to the United States Food and Drug Administration to commence a Phase 1 clinical study of its single-dose intranasal COVID-19 vaccine candidate, AdCOVID.

Released: 25-Nov-2020 11:05 AM EST
BIDMC researchers reveal how genetic variations are linked to COVID-19 disease severity
Beth Israel Lahey Health

New research BIDMC-led sheds light on the genetic risk factors that make individuals more or less susceptible to severe COVID-19.

Newswise: blog-pandemic-scenario-planning-lg-feature2.jpg
Released: 25-Nov-2020 11:05 AM EST
Pandemic Ups Game on Scenario Planning in The Arts
Wallace Foundation

Researcher/Author of new toolkit and report seeks to help arts and culture organizations add scenario planning to their strategic toolbox

Released: 25-Nov-2020 10:30 AM EST
Young people's anxiety levels doubled during first COVID-19 lockdown, says study
University of Bristol

The number of young people with anxiety doubled from 13 per cent to 24 per cent, during the early stages of the COVID-19 pandemic and lockdown 1, according to new research from the University of Bristol.

Newswise: 249837_web.jpg
Released: 25-Nov-2020 10:20 AM EST
Tracking COVID-19 trends in hard-hit states
Louisiana State University

Currently, there are over 10 million confirmed cases and more than 240,000 casualties attributed to COVID-19 in the U.S.

Released: 25-Nov-2020 9:55 AM EST
More Health Systems Join National #MaskUp Campaign
Cleveland Clinic

Many more health systems are joining the national #MaskUp campaign encouraging Americans to stop the spread of COVID-19 by following safety guidelines. Over just a few days, another 19 health systems with hundreds of hospitals united with 100 health systems nationwide with hospitals numbering in the thousands. The public service campaign is critical to the health and well-being of all Americans. It is a plea from healthcare professionals everywhere: wear a mask and follow other precautions to save lives and help get our country back on its feet.

Newswise: delaterre_jpeg.jpg
Released: 25-Nov-2020 7:35 AM EST
Warwick scientists design model to predict cellular drug targets against Covid-19
University of Warwick

The covid-19 virus, like all viruses relies on their host for reproduction

access_time Embargo lifts in 2 days
Embargo will expire: 30-Nov-2020 10:00 AM EST Released to reporters: 24-Nov-2020 5:35 PM EST

A reporter's PressPass is required to access this story until the embargo expires on 30-Nov-2020 10:00 AM EST The Newswise PressPass gives verified journalists access to embargoed stories. Please log in to complete a presspass application. If you have not yet registered, please Register. When you fill out the registration form, please identify yourself as a reporter in order to advance to the presspass application form.


Showing results

110 of 4146

close
1.02912