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COVID-19 Tied to Higher Risk for Large Vessel Occlusion Strokes

FRIDAY, Aug. 7, 2020 -- COVID-19 is associated with large vessel occlusion (LVO) strokes, according to a study published online July 29 in the American Journal of Roentgenology.

Shingo Kihira, M.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues retrospectively reviewed cases for 329 patients for whom a code for stroke was activated (March 16 to April 30, 2020; 53.2 percent men; mean age, 66.9 years) at any of six New York City hospitals within a single health system.

The researchers found that 35.3 percent of patients had acute ischemic stroke confirmed with imaging, 21.6 percent had LVO stroke, and 14.6 percent had small vessel occlusion (SVO) stroke. The most common location among LVO strokes was middle cerebral artery segments M1 and M2 (62 percent). Nearly one in 10 LVOs were multifocal (9.9 percent). More than one-third of stroke patients (38.3 percent) had COVID-19. For stroke-related risk factors, only Hispanic ethnicity was significantly associated with COVID-19 (38.1 percent of patients with COVID-19 versus 20.7 percent of patients without COVID-19). LVO was present in just under one-third of COVID-19 patients (31.7 percent of patients with COVID-19 versus 15.3 percent of patients without COVID-19). Prevalence of SVO was similar between the groups. When controlling for race and ethnicity, presence of COVID-19 was significantly associated with LVO stroke (odds ratio, 2.4).

"Patients with COVID-19 presenting with acute neurologic symptoms warrant a lower threshold for suspicion of large vessel stroke, and prompt workup for large vessel stroke is recommended," the authors write.

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Posted: August 2020

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