Cardioembolic stroke, the most common subtype of stroke in COVID 19: A single center experience from Isfahan, Iran

Marzieh Tajmirriahi; Maryam Masjedi Esfahani; Zahra Amouaghaei; Nahid Mansori; Pantea Miralaei; Sahar Sadat Lalehzar; Peiman Shirani; Mohammad Saadatnia

doi:10.4103/jrms.jrms_594_21

Cardioembolic stroke, the most common subtype of stroke in COVID 19: A single center experience from Isfahan, Iran

J Res Med Sci. 2023 Feb 21:28:10. doi: 10.4103/jrms.jrms_594_21. eCollection 2023.

Authors

Marzieh Tajmirriahi¹, Maryam Masjedi Esfahani¹, Zahra Amouaghaei¹, Nahid Mansori¹, Pantea Miralaei¹, Sahar Sadat Lalehzar¹, Peiman Shirani^{1

2

3}, Mohammad Saadatnia¹

Affiliations

¹ Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
² Department of Neurosurgery, University of Cincinnati, Cincinnati, OH.
³ Department of Neurology, University of Cincinnati, Cincinnati, OH.

Abstract

Background: Some studies showed the cerebrovascular manifestation in patients with recently pandemic coronavirus 2 named the coronavirus disease 2019 (COVID-19). However, there are rare reports about stroke subtypes in these patients. Here, we reported the stroke subtype in patients with laboratory-confirmed diagnosis of COVID-19 and treated at our hospitals, which are located in Isfahan, Iran.

Materials and methods: This is a retrospective, observational case series. Data were collected from March 01, 2020, to May 20, 2020, at three designated special care centers for COVID-19 of Isfahan University of Medical Sciences. The study included 1188 consecutive hospitalized patients with laboratory-confirmed diagnosis of COVID-19.

Results: Of 1188 COVID-19 patients, 7 (0.5%) patients developed stroke. Five (0.4%) had ischemic arterial stroke, 1 (0.08%) hemorrhagic stroke and 1(0.08 %) cerebral venous and sinus thrombosis. Sixty percent of ischemic stroke were cardioembolic stroke (CE) and the rest 2 (40%) were embolic stroke of undetermined source. Three male patients (40%) had stroke as a presenting and admitted symptom of COVID-19. Four patients (57%) had severe COVID-19.

Conclusion: Stroke was an uncommon manifestation in COVID-19 patients. CE was a common subtype of stroke in COVID-19 patients in our centers.

Keywords: COVID-19; embolic stroke; infection; stroke.