To get the statistics acquired, the researchers conducted a Cohort Study in 2 New York hospitals, where they identified, observed, and recorded patients admitted. To collect information on patients’ different characteristics and attributes, the researchers used manual abstraction and automated electronic data capture. Information gathered included demographics, vascular risk factors and diseases, the severity of illness, imaging studies, medications administered, in-hospital mortality, laboratory values, and discharge disposition for patients with COVID-19 and influenza.
Figure 1 shows the timeline it took for patients admitted with COVID-19 symptoms to have an acute ischemic stroke. It took an average of 16 days from COVID-19 symptom onset to diagnose acute stroke (IQR, 5-28 days) (Merkler et al., 2020). It also shows that most of the patients admitted to hospitalized and in ICU experienced acute ischemic stroke. The median age for patients with acute ischemic stroke was determined to be 69 years (IQR, 66-78 years).
In the primary analysis comparing COVID-19 and influenza risk of ischemic stroke, Table 1 focuses on characteristics of patients like their age, sex or presence of vascular risk factors. Table 1 reveals that 31 (1.6%; 95% CI, 1.1%-2.3%) of 1916 COVID-19 participants suffered a stroke. 31 (1.8%; 95% CI, 1.3%-2.6%) hospitalized COVID-19 patients experienced an acute ischemic stroke; no ED treat-and-release patients did. Among 1752 individuals with COVID-19 who arrived at the ED or hospital with viral respiratory disease symptoms, 27 (1.5%; 95% CI, 1.0%-2.2%) had an acute ischemic stroke, while among 998 patients testing positive during universal screening, 19 (1.9%) had an acute ischemic stroke (Merkler et al., 2020). Most patients were older adults with acute ischemic stroke patients, averaging 69 years old (IQR, 66-78 years).
Comparing the risks of having an ischemic stroke and also the characteristics of the stroke in each of the COVID-19 patient groups was done. For instance, the data presented in Table 2 show that patients with COVID-19 were experiencing acute ischemic stroke symptoms. Many of them were experiencing stroke symptoms, and measures had to be taken to prevent it.This included administration of intravenous thrombolysis and the use of antiplatelet and anticoagulants (Merkler et al., 2020). This was to prevent stroke through mechanisms such as cardioembolic and large-artery atherosclerosis, some of the symptoms experienced by patients.
Table 4, 1,916 patients with COVID-19 infection in 2 major hospitals in New York City showed a higher rate of acute stroke than those with influenza. It also focuses on how multiple sensitivity analyses showed consistent results, including studies that accounted for vascular risk variables and ICU admission status, a surrogate for illness severity. By calculating the odds ratio, a COVID-19 patient is 3.47 times more likely to experience an ischemic stroke than a patient with influenza (Sieber et al., 2021). It also considers the demographic composition of patients with people of color likely to get infected with COVID-19 and influenza.
In conclusion, these statistical methods and data analysis provided insight into how influenza and COVID-19 affected patients. By comparing the differences between the two groups of patients, it was possible to determine the disease’s influence on causing acute ischemic stroke. It was evident from the data that those infected with COVID-19 are more likely to experience ischemic strokes than those infected with influenza. This is because COVID-19 typically results in a more severe case of the disease. It was also clear that elderly patients with vascular risk factors and other conditions are more likely to experience an acute ischemic stroke (Josephson & Kamel, 2020). COVID-19 patients experiencing an ischemic stroke were more likely to die than others because they were predisposed to infections, diseases, and stroke.
References
Josephson, S. A., & Kamel, H. (2020). Neurology and COVID-19. Jama, 324(12), 1139-1140.
Merkler, A. E., Parikh, N. S., Mir, S., Gupta, A., Kamel, H., Lin, E., Lantos, J., Schneck, E. J., Goyal, P., Bruce, S. S., Kahan, J., Lansdale, K. N., LeMoss, N. M., Murthy, S. B., Stieg, P. B., Fink, M. E., Ladecola, C., Segal, A. Z., Cusick, M., … & Navi, B. B. (2020). Risk of ischemic stroke in patients with coronavirus disease 2019 (COVID-19) vs patients with influenza. JAMA Neurology, 77(11), 1366-1372.
Sieber, P., Flury, D., Güsewell, S., Albrich, W. C., Boggian, K., Gardiol, C., Schlegel, M., Sieber, R., Vernazza, P., & Kohler, P. (2021). Characteristics of patients with Coronavirus Disease 2019 (COVID-19) and seasonal influenza at time of hospital admission: a single center comparative study. BMC Infectious Diseases, 21(1), 1-9.