Coronavirus Disease 2019 in Patients With Prior Ischemic Stroke

Background: It is uncertain if patients with prior ischemic stroke are vulnerable to coronavirus disease 2019 (COVID-19) and its complications Methods: We used TriNetX, a global health collaborative clinical research platform with a large global COVID-19 database COVID-19 infection was identified with a positive lab value for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and related ribonucleic acid (RNA) Findings: A total of 604,258 patients with history of ischemic stroke were identified, of which 891 patients (study cohort) were diagnosed with COVID-19 A control cohort with 32,136 patients diagnosed with COVID-19 after January 20th 2020 without a history of ischemic stroke were identified A comparison between study cohort and control cohort showed patients with prior history of stroke (study cohort) were older (69 5 vs 47 8;p<0 0001) and had more comorbidities contributing to worse clinical outcomes After propensity matching for demographic variables and comorbidities, only rate of hospitalization (287 vs 231;p=0 0035) and need for critical care services (85 vs 55;p=0 0082) remained statistically significant while intubation (51 vs 43;p=0 39) and death (119 vs 115;p=0 77) showed trends towards worse outcomes but were not statistically significant Interpretation: Patients with history of ischemic stroke tend to be significantly older with several comorbid conditions contributing to worse clinical outcomes after COVID-19, which makes them a vulnerable population