AUTHOR=Huang Huayao , Chen Junnian , Fang Shuangfang , Chen Xiaoling , Pan Xiaobin , Lei Hanhan , Zhang Yixian , Lin Hailong , Yuan Qilin , Xia Pincang , Liu Nan , Du Houwei 

TITLE=Association Between Previous Stroke and Severe COVID-19: A Retrospective Cohort Study and an Overall Review of Meta-Analysis

JOURNAL=Frontiers in Neurology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.922936

DOI=10.3389/fneur.2022.922936

ISSN=1664-2295

ABSTRACT=Objectives: To investigate the association between previous stroke and the risk of severe coronavirus disease 2019 (COVID-19).
Methods: We included 164 (61.8 ±13.6 years) patients with COVID-19 in a retrospective study. We evaluated the unadjusted and adjusted associations between previous stroke and severe COVID-19, using a Cox regression model. We conducted an overall review of systematic review and meta-analysis to investigate the relationship of previous stroke with the unfavorable COVID-19 outcomes.
Results: The rate of severe COVID-19 in patients with previous stroke was 28.37 per 1000-patient days (95% confidence [interval interval, CI] 10.65-75.59), compared to 3.94 per 1000-patient days (95%CI 2.66-5.82) in those without previous stroke (p<0.001). Previous stroke was significantly associated with severe COVID-19 using a Cox regression model (unadjusted [hazard ratio, HR]: 6.98, 95%CI 2.42-20.16, p<0.001; adjusted HR [per additional ten years] 4.62, 95%CI 1.52-14.04, p = 0.007). An overall review of systematic review and meta-analysis showed that previous stroke was significantly associated with severe COVID-19, mortality, need for intensive care unit admission, use of mechanical ventilation, and an unfavorable composite outcome.
Conclusions: Previous stroke seems to influence the course of COVID-19 infection; such patients are at high risk of severe COVID-19 and might benefit from early hospital treatment measures and preventive strategy.