Acute ischemic stroke (AIS) is a common complication of severe acute respiratory syndrome
coronavirus 2 (SARS‑CoV‑2) infection (COVID-19), but the prognosis of these patients
is poorly understood.To explore the impact of COVID-19 on neurological outcomes in
AIS patients.A comparative retrospective cohort study was conducted in 32 consecutive
AIS patients with and 51 without COVID-19 between the 1st of March 2020 and 1st of
May 2021. The evaluation was based on a detailed chart review for demographic data,
medical history, stroke severity, cranial and vessel imaging results, laboratory parameters,
COVID-19 severity, hospitalization time, in-hospital mortality, and functional deficits
at discharge (modified Rankin Scale, mRS).COVID-19 AIS patients showed tendency to
worse initial neurological deficit (NIHSS 9 (3-13) vs. 4 (2-10); p = 0.06), higher
rate of large vessel occlusion (LVO; 13/32 vs. 14/51; p = 0.21), had prolonged hospitalization
(19.4 ± 17.7 vs. 9.7 ± 7 days; p = 0.003), had lower chance of functional independence
(mRS≤2) (12/32 vs. 32/51; p = 0.02) and showed higher in-hospital mortality (10/32
vs. 6/51; p = 0.02). In COVID-19 AIS patients, LVO was more common with COVID-19 pneumonia
than without (55.6% vs. 23.1%; p = 0.139).COVID-19-related AIS carries a worse prognosis.
COVID-19 with pneumonia seems to be associated with a higher rate of LVO.
