Higher mortality in stroke patients with active COVID-19 infection

Mostafa Almasi-Dooghaee; Seyedehnarges Tabatabaee; Fatemeh Moghadas; Tara Khoeini; Mona Ramezani Ghamsari; Tayebeh Lotfi; Matineh Heidari; Zakieh Shafiei; Roya Yazdani; Zahra Mirzaasgari; Seyed Mohammad Tabatabaei; Mehdi Moghaddasi; Abdol-Hossein Vahabie

doi:10.37349/ent.2025.1004109

Exploration of Neuroprotective Therapy ›› 2025, Vol. 5 ›› Issue (1) :1004109 DOI: 10.37349/ent.2025.1004109

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Higher mortality in stroke patients with active COVID-19 infection

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¹ Department of Neurology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran 1911883611, Iran

² Rasoul Akram Clinical Research Development Unit (RACRD), Iran University of Medical Sciences, Tehran 1981685113, Iran

³ Department of Neurology, Rasoul Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran 1981685113, Iran

⁴ Clinical Research Development Center of Shahid Rajaei, Alborz University of Medical Sciences, Karaj 3154686695, Iran

⁵ Department of Electrical and Computer Engineering, University of Tehran, Tehran 1914395515, Iran

⁶ Cognitive Systems Laboratory, Control and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran 1914395515, Iran

⁷ Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran 1941556456, Iran

⁸ School of Cognitive Sciences, Institute for Research in Fundamental Sciences, Tehran 1953833511, Iran

^* Seyedehnarges Tabatabaee, Department of Neurology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran 1911883611, Iran.nrgstaba@gmail.com

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Abstract

Aim:Our previous research (Abstract, J Vessels Circ. 2021;2) suggested an increased risk of thrombotic events, including ischemic strokes, in patients with COVID-19. This study aims to determine the mortality rate and its predictors in patients with stroke and concurrent COVID-19 infection.
Methods:A retrospective analysis was conducted on stroke patients admitted to three Iranian referral hospitals within a 3-month period during the COVID-19 pandemic (COV-pos and COV-neg groups). The mortality rate was compared to a similar period one year before the pandemic (non-COV group). The Cox proportional hazards model was used to assess the independent and interactive effects of various variables on mortality.
Results:Among 124 stroke admissions, 59 (47.6%) had confirmed COVID-19 infection. The COV-pos group had a significantly higher initial NIHSS score (P = 0.001) compared to other groups. Mortality rates were 49.2%, 24.2%, and 17.3% in the COV-pos, COV-neg, and non-COV groups, respectively (P ＜ 0.001). Posterior cerebral artery (PCA) stroke (HR = 65.099), internal carotid artery (ICA) stroke (HR = 19.102), and a history of diabetes mellitus (HR = 3.824) were identified as the most significant predictors of mortality in patients with stroke and COVID-19 infection.
Conclusions:Stroke patients with COVID-19 infection exhibited a significantly higher mortality rate compared to patients without COVID-19. The type of stroke involving the PCA or ICA and a history of diabetes emerged as the strongest predictors of mortality in the studied population.

Keywords

COVID-19 infection / pandemics / stroke / mortality

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Mostafa Almasi-Dooghaee, Seyedehnarges Tabatabaee, Fatemeh Moghadas, Tara Khoeini, Mona Ramezani Ghamsari, Tayebeh Lotfi, Matineh Heidari, Zakieh Shafiei, Roya Yazdani, Zahra Mirzaasgari, Seyed Mohammad Tabatabaei, Mehdi Moghaddasi, Abdol-Hossein Vahabie. Higher mortality in stroke patients with active COVID-19 infection. Exploration of Neuroprotective Therapy, 2025, 5 (1) : 1004109 DOI:10.37349/ent.2025.1004109

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