- Hemorrhagic stroke rates were low overall among patients in New York City hospitalized with COVID-19.
- Patients who did have stroke tended to be taking anticoagulants.
Why this matters
- The authors say that their findings suggest that neurological evaluation is imperative and that patients would benefit from several tactics, including:
- Attempts to wean from sedation for neurologic exams, especially if on anticoagulants.
- CT screening before initiating anticoagulation.
- 34 of 4071 patients who were hospitalized with COVID-19 had hemorrhagic stroke.
- 78.9% were men.
- The authors excluded 15 of the 34 patients who had hemorrhagic stroke from the analysis because these cases involved transformation of ischemic stroke.
- Only 2 of 19 patients were not on an anticoagulant before the stroke.
- The indication for anticoagulation was suspected COVID-19 hypercoagulability in 11 of 17.
- Most patients were started on hydroxychloroquine; about a quarter were started on IL-6.
- 84.2% with hemorrhagic stroke were on mechanical ventilation.
- The group with stroke had a mortality rate of 84.6%, compared with 5.0% of historic controls (P≤.001).
- Retrospective cohort study of patients hospitalized March 1-May 15, 2020.
- Funding: None specific to this work cited.
- Some strokes may have been missed.
- Use of hydroxychloroquine was revoked after the study period.