NEW DELHI: The first study of stroke among Covid-19 patients in India compared with stroke patients prior to the pandemic has shown unexpected high mortality and has suggested that many suffered strokes without conventional risk factors.
Over a three-month period, a group of neurologists observed disease features and outcomes in 62 stroke patients from 13 hospitals across Bangalore, and compared them with 111 stroke patients they had treated during the same three months last year.
Their findings showed an unusually high proportion of patients — one in four, or 16 of the 62 (26%) — did not have conventional risk factors for stroke such as hypertension, cardiovascular disease or diabetes.
Also, a high proportion of patients — 37 of the 62 (59%) — had residual neurological disability scores — neurological issues even after recovery— of 3-5 at discharge.
The score 3 means moderate disability where patient needs some help but can walk without assistance, 4 suggests moderate disability, with patient being unable to walk and attend to needs without assistance and 5 indicates severe disability where the patient is bed-ridden, incontinent and needs constant nursing care and attention.
The observational study showed that 13 of the 62 patients (16%) with Covid-19 and stroke died, which the neurologists say is high and not observed during routine non-Covid strokes. Of the patients observed, 60 (97%) had ischemic strokes (caused by a blockage in an artery that supplies blood to the brain) while 2 (3%) had hemorrhagic strokes (when blood from an artery begins bleeding into the brain). The mean age of patients was 55 years, with 34 (77.4%) males.
For the multicentre retrospective study of all patients from 13 hospitals from south India between June and August this year, demographic, clinical, laboratory and neuroimaging data were collected along with treatment administered and outcomes. SARS-CoV-2 infection was confirmed in all cases by RT- PCR testing. Twenty-six per cent (16/62) of patients did not have any conventional risk factors for stroke. Diabetes Mellitus was seen in 54.8%, hypertension was present in 61.3%, coronary artery disease in 8% and atrial fibrillation in 4.8%.