Mortality Rate And Biomarker Expression Within Covid-19 Patients Who Develop Acute Ischemic Stroke: A Systematic Review And Meta-Analysis

Objective: To describe the mortality difference between acute ischemic stroke (AIS) and non-AIS groups within COVID-19 patients. Materials & methods: We included observational studies through September 2020 that categorized COVID-19 patients into two groups (with and without AIS). Results: Eight studies with a total sample size of 19,399 COVID-19 patients were included. The pooled risk difference showed that patients with COVID-19 who developed AIS had significantly higher mortality than those without AIS by a risk difference of 24% (95% CI: 0.10-0.39; p = 0.001). In two studies, the COVID-19+AIS group had significantly higher lymphocytes, procalcitonin and creatinine levels. Conclusion: Developing AIS significantly adds to the mortality of COVID-19. Timely interventions to manage those patients are strongly recommended.Lay abstract We systematically searched for COVID-19 studies that categorized patients into two groups: with and without acute ischemic stroke (AIS). Of 5100 unique records, eight studies with a total of 19,399 COVID-19 patients were included. The overall mortality rate of COVID-19 patients who developed AIS was 29.6% compared with 2.6% in those without AIS. We therefore conclude that development of AIS increases the mortality rate of COVID-19, and recommend timely intervention for such patients.