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Cited by 584

The DOI matches its Crossref record; 11 of the 11 references it cites were found in a registry or an index.

Stroke in COVID-19: A systematic review and meta-analysis

Open access
Nannoni, Stefania, de Groot, Rosa, Bell, Steven, Markus, Hugh S·2021·International Journal of Stroke
DOI 10.1177/1747493020972922
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Abstract

Background: Coronavirus disease 2019 (COVID-19) has become a global pandemic, affecting millions of people. However, the relationship between COVID-19 and acute cerebrovascular diseases is unclear. Aims: We aimed to characterize the incidence, risk factors, clinical–radiological manifestations, and outcome of COVID-19-associated stroke. Methods: Three medical databases were systematically reviewed for published articles on acute cerebrovascular diseases in COVID-19 (December 2019–September 2020). The review protocol was previously registered (PROSPERO ID = CRD42020185476). Data were extracted from articles reporting ≥5 stroke cases in COVID-19. We complied with the PRISMA guidelines and used the Newcastle–Ottawa Scale to assess data quality. Data were pooled using a random-effect model. Summary of review: Of 2277 initially identified articles, 61 (2.7%) were entered in the meta-analysis. Out of 108,571 patients with COVID-19, acute CVD occurred in 1.4% (95%CI: 1.0–1.9). The most common manifestation was acute ischemic stroke (87.4%); intracerebral hemorrhage was less common (11.6%). Patients with COVID-19 developing acute cerebrovascular diseases, compared to those who did not, were older (pooled median difference = 4.8 years; 95%CI: 1.7–22.4), more likely to have hypertension (OR = 7.35; 95%CI: 1.94–27.87), diabetes mellitus (OR = 5.56; 95%CI: 3.34–9.24), coronary artery disease (OR = 3.12; 95%CI: 1.61–6.02), and severe infection (OR = 5.10; 95%CI: 2.72–9.54). Compared to individuals who experienced a stroke without the infection, patients with COVID-19 and stroke were younger (pooled median difference = −6.0 years; 95%CI: −12.3 to −1.4), had higher NIHSS (pooled median difference = 5; 95%CI: 3–9), higher frequency of large vessel occlusion (OR = 2.73; 95%CI: 1.63–4.57), and higher in-hospital mortality rate (OR = 5.21; 95%CI: 3.43–7.90). Conclusions: Acute cerebrovascular diseases are not uncommon in patients with COVID-19, especially in those whom are severely infected and have pre-existing vascular risk factors. The pattern of large vessel occlusion and multi-territory infarcts suggests that cerebral thrombosis and/or thromboembolism could be possible causative pathways for the disease.

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Metadata

Authors
Nannoni, S., de Groot, R., Bell, S., & Markus, H. S.
Venue
International Journal of Stroke
Publisher
SAGE Publications
Published
2020-11-11
Volume
16
Issue
2
Pages
137-149
ISSN
  • 1747-4930 (ISSN-L)
  • 1747-4949
DOI
10.1177/1747493020972922
OpenAlex
W3093968859
Cited by
584
References
11
FWCI
16.05
Type
journal article
Language
en
Open access
hybrid

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CoChat. (2026). Citation check: Stroke in COVID-19: A systematic review and meta-analysis. https://app.cochat.ai/papers/10.1177/1747493020972922
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Nannoni, S., de Groot, R., Bell, S., & Markus, H. S. (2021). Stroke in COVID-19: A systematic review and meta-analysis. International Journal of Stroke. https://doi.org/10.1177/1747493020972922

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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