Abstract Body: Introduction
The association between comorbidities and poor functional outcome in patients with non-COVID-19 ischemic stroke (IS) is well-established. This report aims to examine the differences in the distribution of comorbidities between COVID-19 IS patients with a devastating functional outcome and those without. Additionally, the impact of comorbidities on oxygenation and ICU admission was assessed.
Methods
The data was queried from the NIH COVID-19 NeuroDatabank. We included hospitalized COVID-19 patients who developed IS and had available outcome data. A devastating functional outcome was defined as a modified Rankin Scale (mRS) >= 5 at hospital discharge. Individual comorbid conditions and comorbidity burden were examined. Wilcoxon signed-rank test and Fisher’s exact test were used. Multivariate regression was conducted for variables with significant differences.
Results
Three hundred twenty-seven hospitalized COVID-19 IS patients were included; mean age: 63 years; males 57.9%. Out of 290 cases with mRS data, 120 (41.4%) had an mRS score >= 5 at discharge. Individual comorbidities showed no significant difference between mRS groups except for a higher frequency of asthma (p = 0.018) and kidney disease (p = 0.017) in the devastating outcome group. The number of cases with two or more non-communicable diseases (NCDs) was significantly higher in the mRS >= 5 group (p = 0.013). A Charlston Comorbidity Index-derived score was also higher in the devastating outcome group (mean[SD] = 2.04[1.96] vs. 1.57[1.7], p = 0.032).
Out of 288 cases with oxygenation data, 193 cases received oxygen. The frequency of diabetes and the burden of NCDs were significantly higher in oxygenated cases (p = 0.028 & 0.034, respectively).
Out of 278 cases with ICU data, 186 received ICU admission. Admitted cases had significantly lower mean age, frequency of stroke &/or dementia, psychiatric disorders, and hypertension. The frequency of asthma was significantly higher in ICU admitted patients. Multivariate regression analysis showed no significant association between any of the comorbidities or scores and oxygenation or ICU admission.
Conclusion
Comorbidities associated with poor functional outcome in non-COVID-19 IS patients showed no differences among outcome groups in COVID-19 IS patients. Demographics, COVID-19-related and hospitalisation factors, appear to play a more pronounced role in shaping the outcomes in this group. The small sample size and retrospective nature limit the study.