Stroke etiologies in patients with COVID-19: the SVIN COVID-19 multinational registry

Ramos-Araque, María E.; Siegler, James E.; Ribo, Marc; Requena, Manuel; López, Cristina; de Lera, Mercedes; Arenillas, Juan F.; Pérez, Isabel Hernández; Gómez-Vicente, Beatriz; Talavera, Blanca; Portela, Pere Cardona; Guillen, Ana Nuñez; Urra, Xabier; Llull, Laura; Renú, Arturo; Nguyen, Thanh N.; Jillella, Dinesh; Nahab, Fadi; Nogueira, Raul; Haussen, Diogo; Then, Ryna; Thon, Jesse M.; Esparragoza, Luis Rodríguez; Hernández-Pérez, Maria; Bustamante, Alejandro; Mansour, Ossama Yassin; Megahed, Mohammed; Hassan, Tamer; Liebeskind, David S.; Hassan, Ameer; Bushnaq, Saif; Osman, Mohamed; Vazquez, Alejandro Rodriguez

doi:10.1186/s12883-021-02075-1

BMC Neurology

Table 1 Demographic data

From: Stroke etiologies in patients with COVID-19: the SVIN COVID-19 multinational registry

	All patients acute ischemic stroke^a (n = 156)	Cryptogenic stroke (n = 55)	Cardioembolic stroke (n = 35)	Large vessel stroke (n = 15)	Small vessel stroke (n = 4)	Other (n = 11)	p-value^b	p-value^c
Age, no. (%)							0.10	0.97
< 30	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)
30–39	3 (2.5)	1 (1.8)	2 (5.7)	0 (0)	0 (0)	2 (18.2
40–49	12 (10.0)	6 (10.9)	2 (5.7)	0 (0)	0 (0)	4 (36.4)
50–59	15 (12.5)	6 (10.9)	5 (14.3)	2 (13.3)	0 (0)	2 (18.2)
60–69	36 (30.0)	19 (34.6)	8 (22.9)	6 (40.0)	1 (25.0)	2 (18.2)
70–79	37 (30.8)	16 (29.1)	13 (37.1)	5 (33.3)	2 (50.0)	1 (9.1)
80–89	12 (10.0)	5 (9.1)	4 (11.4)	2 (13.3)	1 (25.0)	0 (0)
> 89	5 (4.2)	2 (3.6)	3 (8.6)	0 (0)	0 (0)	0 (0)
Sex, no. female (%)	61/155 (39.4)	19/55 (34.6)	15/35 (42.9)	5/14 (35.7)	0/4 (0)	8/11 (72.7)	0.08	0.45
Race, no. (%)							0.52	> 0.9
White	84/125 (67.2)	31/45 (68.9)	21/28 (75.0)	9/12 (75.0)	2/3 (66.7)	5/10 (50.0)
Black	35/125 (28.0)	12/45 (26.7)	7/28 (25.0)	2/12 (16.7)	1/3 (33.3)	4/10 (40.0)
Asian	2/125 (1.6)	1/45 (2.2)	0/28 (0)	0/12 (0)	0/3 (0)	0/10 (0)
More than one race	2/125 (1.6)	1/45 (2.2)	0/28 (0)	1/12 (8.3)	0/3 (0)	0/10 (0)
Other	2/125 (1.6)	0/45 (0)	0/28 (0)	0/12 (0)	0/3 (0)	1/10 (0)
Hispanic ethnicity, no. (%)	58/140 (41.4)	25/49 (51.0)	10/33 (30.3)	4/12 (33.3)	4/4 (100)	10/11 (90.9)	0.02	0.05
Diagnosis of COVID-19 ^d, no. (%)							0.11	0.83
Nasopharyngeal PCR	153 (98.1)	55/55 (100)	35/35 (100)	15/15 (100)	4/4 (100)	10/11 (90.9)
Serum IgM and/or IgG	6 (3.8)	2/55 (3.6)	3/35 (8.6)	0/15 (0)	1/4 (25.0)	1/11 (9.1)
Known COVID-19 exposure, no. (%)	19 (12.2)	8/55 (14.6)	5/35 (14.3)	1/15 (6.7)	0/4 (0)	2/11 (18.2)	0.82	0.69
Medical history, no. (%)
Hypertension	111/154 (72.1)	38/53 (71.7)	26/35 (74.3)	12/15 (80.0)	4/4 (100)	4/11 (36.4)	0.10	0.87
Diabetes mellitus	65/152 (42.8)	22/51 (43.1)	13/35 (37.1)	5/15 (33.3)	2/4 (50.0)	7/11 (63.6)	0.56	0.87
Dyslipidemia	58/142 (40.9)	18/53 (34.0)	17/35 (48.9)	7/15 (46.7)	3/4 (75.0)	0/11 (0)	0.01	0.33
Atrial fibrillation	22/148 (14.9)	0/52 (0)	16/35 (45.7)	0/15 (0)	0/4 (0)	0/11 (0)	< 0.01	< 0.01
Congestive heart failure	27/154 (17.5)	5/53 (9.4)	9/35 (25.7)	4/15 (26.7)	0/4 (0)	1/11 (9.1)	0.17	0.05
Active tobacco use	15/145 (10.3)	4/52 (7.7)	5/33 (15.2)	0/15 (0)	1/4 (25.0)	0/11 (0)	0.21	0.68
Prior stroke	15/140 (10.7)	6/42 (12.5)	2/33 (6.1)	0/13 (0)	0/4 (0)	0/11 (0)	0.59	0.33
Chronic renal insufficiency (stage III/IV or dialysis-dependent)	16/144 (11.1)	3/47 (6.4)	1/33 (3.0)	2/13 (15.4)	0/4 (0)	3/11 (27.3)	0.11	0.49
Chronic obstructive pulmonary disease and/or asthma	11/135 (8.2)	2/48 (4.2)	3/33 (9.1)	0/13 (0)	1/4 (25.0)	0/11 (0)	0.28	0.24
Cancer	8/134 (6.0)	4/47 (8.5)	1/33 (2.9)	0/13 (0)	1/4 (25.0)	0/11 (0)	0.29	0.35
Premorbid mRS, median (IQR)	0 (0–1) (n = 124)	0 (0–0) (n = 49)	0 (0–1) (n = 33)	0 (0–0) (n = 13)	0 (0–1) (n = 4)	0 (0–0) (n = 10)	0.54	> 0.9

Of the 11 patients with ‘Other’ etiologies, 2 had hypercoagulable states due to malignancy, 1 with hypercoagulability on laboratory testing unrelated to malignancy, 2 with arterial dissection, 1 with vasculitis due to mucormycosis, 3 with radiographic findings of posterior reversible encephalopathy with infarction, and 2 with etiologies not otherwise specified
^a Acute ischemic stroke includes suspected or radiographically-confirmed cases, and in patients with multiple possible stroke mechanisms (n = 9). Patients with multiple stroke mechanisms were not included in the subsequent columns in order to minimize heterogeneity
^b P-values indicate categorical comparisons between all stroke subtypes
^c P-values indicate comparisons between cryptogenic and non-cryptogenic stroke subtypes (including strokes due to multiple possible etiologies)
^d 3 patients with an acute ischemic stroke were diagnosed with COVID-19 using both serum antibodies and nasopharyngeal PCR. COVID-19 denotes coronavirus disease 2019, PCR polymerase chain reaction

Back to article page

ISSN: 1471-2377

Contact us

General enquiries: journalsubmissions@springernature.com