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Archives of Academic Emergency Medicine

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  3. Vol. 12 No. 1 (2024): Continuous volume
  4. Review Article

Vol. 12 No. 1 (2024)

Dey 2024

Stroke and COVID-19: An Umbrella Review Stroke and COVID-19

  • Kavous Shahsavarinia
  • Nasim Hajipoor kashgsaray
  • Morteza Ghojazadeh
  • Zahra Falaki
  • Maryam Soleimanpour
  • Hassan Soleimanpour

Archives of Academic Emergency Medicine, Vol. 12 No. 1 (2024), 1 Dey 2024 , Page e65
https://doi.org/10.22037/aaemj.v12i1.2385 Published: 2024-08-25

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Abstract

Introduction: Acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) are among the acute cerebrovascular diseases (CVDs) that have been reported as a result of COVID-19. It will be a significant step forward if our research helps improve the compilation and analysis of existing data from other studies.

Methods: The study is registered on PROSPERO with an ID of CRD42023464058. It encompasses articles published until December 2023 and involves searching databases such as PubMed, Scopus, Web of Knowledge, Embase, and Cochrane. Additionally, we conducted manual searches in respected publications within this discipline, utilized the Google Scholar search engine, and conducted reference checks, citation checks, and study of gray literature. The publications’ reporting quality was assessed using the "Assessment of Multiple Systematic Reviews" (AMSTAR) checklist. The meta-analysis was conducted using Stata software (StataCorp, version 16).

Results: We analyzed the findings of 23 meta-analyses, which included 795 articles and encompassed 5,937 patients who had previously experienced a stroke. The average age of these patients was 62.3 years, and 68.3% were male. The findings indicated that the collective incidence of stroke among individuals with COVID-19 is roughly 1.75% [95% confidence interval (CI): 0.4%-3.03], with 1.59% for ischemic strokes and 0.3% for hemorrhagic strokes. 32.3% (95% CI: 27.8%-36.9%) of COVID-19 patients with stroke passed away, approximately 27% were discharged from the hospital with very mild or no complications, and around 28.1% (95% CI: 14.1%-42.1%) were referred for rehabilitation.

Conclusions: The overall rate of stroke in COVID-19 patients was approximately 1.75%, with a higher incidence in males and those with an average age of 62.3 years. Almost 80% of the strokes were ischemic, and the mortality rate was approximately 32%. Finally, 27% of the patients were discharged without complications, and 28% required rehabilitation.

Keywords:
  • COVID-19
  • Ischemic stroke
  • Hemorrhagic stroke
  • Systematic review
  • Meta-analysis
  • pdf

How to Cite

1.
Shahsavarinia K, Hajipoor kashgsaray N, Ghojazadeh M, Falaki Z, Soleimanpour M, Soleimanpour H. Stroke and COVID-19: An Umbrella Review: Stroke and COVID-19. Arch Acad Emerg Med [Internet]. 2024 Aug. 25 [cited 2026 Feb. 7];12(1):e65. Available from: https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/2385
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References

Bagi HM, Soleimanpour M, Abdollahi F, Soleimanpour H. Evaluation of clinical outcomes of patients with mild symptoms of coronavirus disease 2019 (COVID-19) discharged from the emergency department. PLoS One. 2021;16(10):e0258697.

Shahsavarinia K, Ghojazadeh M, Ghabousian A, Hatefnia F, Soleimanpour M, Soleimanpour H. An Umbrella Review of Clinical Efficacy and Adverse Cardiac Events Associated with Hydroxychloroquine or Chloroquine with or Without Azithromycin in Patients with COVID-19. Anesth Pain Med. 2021 Aug 15;11(4):e115827.

Gralinski LE, Menachery VD. Return of the Coronavirus: 2019-nCoV. Viruses. 2020;12(2).

Iyengar K, Bahl S, Raju V, Vaish A. Challenges and solutions in meeting up the urgent requirement of ventilators for COVID-19 patients. Diabetes Metab Syndr. 2020;14(4):499-501.

Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. 2020;77(6):683-90.

Zurrú MC, Alonzo C, Brescacín L, Romano M, Cámera LA, Waisman G, et al. Recent respiratory infection predicts atherothrombotic stroke: case-control study in a Buenos Aires healthcare system. Stroke. 2009;40(6):1986-90.

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62.

Spence JD, de Freitas GR, Pettigrew LC, Ay H, Liebeskind DS, Kase CS, et al. Mechanisms of Stroke in COVID-19. Cerebrovasc Dis. 2020;49(4):451-8.

Ayromlou H, Soleimanpour H, Farhoudi M, Sadeghi-Hokmabadi E, Rajaei Ghafouri R, Sharifipour E, et al. What are the most important barriers for thrombolytic therapy in ischemic stroke patients? Int J Stroke. 2013;8(4):E7.

Nikbakht H-A, Shojaie L, Niknejad N, Hassanipour S, Soleimanpour H, Heidari S, et al. Mortality rate of acute stroke in Iran: a systematic review and meta-analysis. Caspian Journal of Neurological Sciences. 2022;8(4):252-67.

Soleimanpour H, Pashapour A, Mohammadi N, Golzari SE, Khodaverdizadeh H. Juvenile ischemic stroke secondary to cardiogenic embolism: a rare case report. Int J Prev Med. 2014;5(1):117-22.

Zakeri A, Jadhav AP, Sullenger BA, Nimjee SM. Ischemic stroke in COVID-19-positive patients: an overview of SARS-CoV-2 and thrombotic mechanisms for the neurointerventionalist. J Neurointerv Surg. 2021;13(3):202-6.

Avula A, Nalleballe K, Narula N, Sapozhnikov S, Dandu V, Toom S, et al. COVID-19 presenting as stroke. Brain Behav Immun. 2020;87:115-9.

Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1.

Aromataris E, Fernandez R, Godfrey CM, Holly C, Khalil H, Tungpunkom P. Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach. Int J Evid Based Healthc. 2015;13(3):132-40.

Shea BJ, Grimshaw JM, Wells GA, Boers M, Andersson N, Hamel C, et al. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol. 2007;7:10.

Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. Bmj. 2003;327(7414):557-60.

Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. Bmj. 1997;315(7109):629-34.

Pieper D, Antoine SL, Mathes T, Neugebauer EA, Eikermann M. Systematic review finds overlapping reviews were not mentioned in every other overview. J Clin Epidemiol. 2014;67(4):368-75.

Athanasios A, Daley I, Patel A, Oyesanmi O, Desai P, Frunzi J. Cerebrovascular Accident and SARS-CoV-19 (COVID-19): A Systematic Review. Eur Neurol. 2021;84(6):418-25.

Bhatia R, Pedapati R, Komakula S, Srivastava MVP, Vishnubhatla S, Khurana D. Stroke in Coronavirus Disease 2019: A Systematic Review. J Stroke. 2020;22(3):324-35.

Castro-Varela A, Martinez-Magallanes DM, Reyes-Chavez MF, Gonzalez-Rayas JM, Paredes-Vazquez JG, Vazquez-Garza E, et al. Risk Factors, Clinical Presentation, Therapeutic Trends, and Outcomes in Arterial Thrombosis Complicating Unvaccinated COVID-19 Patients: A Systematic Review. Angiology. 2024;75(7):625-34.

Daly SR, Nguyen AV, Zhang Y, Feng D, Huang JH. The relationship between COVID-19 infection and intracranial hemorrhage: A systematic review. Brain Hemorrhages. 2021;2(4):141-50.

Fridman S, Bres Bullrich M, Jimenez-Ruiz A, Costantini P, Shah P, Just C, et al. Stroke risk, phenotypes, and death in COVID-19: Systematic review and newly reported cases. Neurology. 2020;95(24):e3373-e85.

Katsanos AH, Palaiodimou L, Zand R, Yaghi S, Kamel H, Navi BB, et al. The Impact of SARS-CoV-2 on Stroke Epidemiology and Care: A Meta-Analysis. Ann Neurol. 2021;89(2):380-8.

Lee KW, Yusof Khan AHK, Ching SM, Chia PK, Loh WC, Abdul Rashid AM, et al. Stroke and Novel Coronavirus Infection in Humans: A Systematic Review and Meta-Analysis. Front Neurol. 2020;11:579070.

Li S, Ren J, Hou H, Han X, Xu J, Duan G, et al. The association between stroke and COVID-19-related mortality: a systematic review and meta-analysis based on adjusted effect estimates. Neurol Sci. 2022;43(7):4049-59.

Luo W, Liu X, Bao K, Huang C. Ischemic stroke associated with COVID-19: a systematic review and meta-analysis. J Neurol. 2022;269(4):1731-40.

Menezes RG, Alabduladhem TO, Siddiqi AK, Maniya MT, Al Dahlawi AM, Almulhim MWA, et al. Cerebrovascular disease in COVID-19: a systematic review and meta-analysis. Infez Med. 2023;31(2):140-50.

Nannoni S, de Groot R, Bell S, Markus HS. Stroke in COVID-19: A systematic review and meta-analysis. Int J Stroke. 2021;16(2):137-49.

Parsay S, Vosoughi A, Khabbaz A, Sadigh-Eteghad S. The Incidence and Mortality Ratio of Ischemic Cerebrovascular Accidents in COVID-19 Cases: A Systematic Review and Meta-Analysis. J Stroke Cerebrovasc Dis. 2021;30(3):105552.

Siepmann T, Sedghi A, Simon E, Winzer S, Barlinn J, de With K, et al. Increased risk of acute stroke among patients with severe COVID-19: a multicenter study and meta-analysis. Eur J Neurol. 2021;28(1):238-47.

Siow I, Lee KS, Zhang JJY, Saffari SE, Ng A, Young B. Stroke as a Neurological Complication of COVID-19: A Systematic Review and Meta-Analysis of Incidence, Outcomes and Predictors. J Stroke Cerebrovasc Dis. 2021;30(3):105549.

Syahrul S, Maliga HA, Ilmawan M, Fahriani M, Mamada SS, Fajar JK, et al. Hemorrhagic and ischemic stroke in patients with coronavirus disease 2019: incidence, risk factors, and pathogenesis - a systematic review and meta-analysis. F1000Res. 2021;10:34.

Szegedi I, Orbán-Kálmándi R, Csiba L, Bagoly Z. Stroke as a Potential Complication of COVID-19-Associated Coagulopathy: A Narrative and Systematic Review of the Literature. J Clin Med. 2020;9(10).

Tan YK, Goh C, Leow AST, Tambyah PA, Ang A, Yap ES, et al. COVID-19 and ischemic stroke: a systematic review and meta-summary of the literature. J Thromb Thrombolysis. 2020;50(3):587-95.

Trepet G, Radzikhovska N. Ischemic Stroke in COVID-19: A Systematic Review. Journal of Pharmaceutical Research International. 2021;33(60B):2412-20.

Vidale S. Risk Factors, and Clinical and Etiological Characteristics of Ischemic Strokes in COVID-19-Infected Patients: A Systematic Review of Literature. Cerebrovasc Dis. 2021;50(4):371-4.

Yamakawa M, Kuno T, Mikami T, Takagi H, Gronseth G. Clinical Characteristics of Stroke with COVID-19: A Systematic Review and Meta-Analysis. J Stroke Cerebrovasc Dis. 2020;29(12):105288.

Yao Z, Huang L, Cheng Y, Qi R, Xu B, Zhang Q, et al. Clinical characteristics and outcomes of acute ischemic stroke in patients with COVID-19: A systematic review and meta-analysis of global data. Advanced Neurology. 2022;1(1):28.

Yu T, Wang H, Zheng S, Huo L. SARS-CoV-2-associated cerebrovascular disease amid the COVID-19 pandemic: A systematic review. Infection and Drug Resistance. 2021:4967-75.

Cui Y, Zhao B, Li T, Yang Z, Li S, Le W. Risk of ischemic stroke in patients with COVID-19 infection: A systematic review and meta-analysis. Brain Res Bull. 2022;180:31-7.

Perry RJ, Smith CJ, Roffe C, Simister R, Narayanamoorthi S, Marigold R, et al. Characteristics and outcomes of COVID-19 associated stroke: a UK multicentre case-control study. J Neurol Neurosurg Psychiatry. 2021;92(3):242-8.

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