COVID-19 with stroke - Clinical characteristics and outcomes at King Abdulaziz Medical City, MNGHA, Riyadh, KSA

Objective: To present single center experience of stroke in COVID-19 patients from a tertiary care hospital in Saudi Arabia. Background: Coronavirus Disease-2019 (COVID-19) has affected millions of people across the world and has been associated with increased the risk of stroke. We report clinical characteristics and outcome of COVID-19 patients with stroke. Design/Methods: This is a single center, case series of COVID-19 patients with stroke presenting to King Abdulaziz Medical City, MNGHA, Riyadh, Saudi Arabia. Charts of stroke patients with COVID-19 admitted between March 1 and July 31, 2020 were reviewed. Results: We identified 12 patients with COVID presenting with stroke, of whom 10 (83%) were male with mean age of 57± 12 (range 32 - 82) years. Six (50%) patients were Saudi. Majority of patients 9 (75%) arrived to emergency room after 6 hours of stroke onset. Ten (83%) patients had mild to moderate stroke at presentation (NIHSS 0 - 15). Hemorrhagic stroke was seen in 5 (42%) patients, whereas 7 (58%) had ischemic stroke. Among patients with hemorrhagic stroke, multifocal hemorrhage was seen in 3 (60%), while 2 (40%) had deep basal ganglia hemorrhage. Hypertension was present in 10 (83%) patients and diabetes mellitus in 6 (50%). Median length of hospitalization was 17 (8 - 34) days, with 7 (63%) patients discharged home with good functional status, (mRS 0-2). Mortality was seen among 2 (29%) patients with ischemic stroke and one with hemorrhagic stroke. The mean age of patients who died was 67±13 compared to alive was 53±11years. Conclusions: In conclusion, ischemic stroke was more common among patients with COVID-19 and had higher mortality compared to patients with hemorrhagic stroke. The patient who died on an average were 10 years elder to others. Having diabetes, hypertension and higher severity of stroke at presentation were associated with poor outcome.