Predictors of Poor Outcome in COVID-19 Patients with Acute Ischemic Stroke

Objective: Identify predictors of poor outcome in patients with COVID-19 disease and Acute Ischemic Stroke (AIS). Background: SARS-CoV-2 infection is associated with a strong inflammatory and procoagulable state, leading to thromboembolic events. COVID-19 patients with AIS tend to have worse outcomes compared with non-COVID AIS patients. Design/Methods: AIS patients with and without COVID-19 disease, admitted between March 15–May 15, 2020 to one of the six major comprehensive stroke centers from Chicago area were included in this study. Stroke was diagnosed based on neuroimaging findings. SARS-CoV-2 infection was diagnosed based on RT-PCR testing. Patients were dichotomized based on outcome at hospital discharge. Poor outcome was defined as Modified Rankin Scale score (mRS) of 3–6. Univariate and multivariate analyses were developed to identify predictors of outcome. Results: Out of 194 patients with AIS, 32% tested positive for SARS-CoV-2 and 60% had poor outcome. In univariate analysis, poor outcome for COVID-19 patients was associated with pre-existing hypertension and higher NIHSS score at stroke onset (p Conclusions: Pre-existing diabetes and renal disease remain the most important predictors of worse outcome in stroke patients with COVID-19 disease. Disclosure: Dr. Trifan has nothing to disclose. Dr. Goldenberg has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Legal expert review. The institution of Dr. Goldenberg has received research support from Gift of Hope. Dr. Caprio has received personal compensation in the range of $0-$499 for serving as a Consultant for Medtronic. Dr. Caprio has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie. An immediate family member of Dr. Biller has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Stroke and Cerebrovascular Diseases. Dr. Biller has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Stroke and Cerebrovascular Diseases. Dr. Biller has received publishing royalties from a publication relating to health care. An immediate family member of Dr. Schneck has received personal compensation for serving as an employee of Histogenx. Dr. Schneck has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for HLT Medical. Dr. Schneck has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Miscellaneous legal firms. The institution of Dr. Schneck has received research support from NIH. Dr. Khaja has nothing to disclose. Dr. Brorson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for National Peer Review Corporation. Dr. Brorson has a non-compensated relationship as a Vascular Neurology Pilot Committee with American Board of Psychiatry and Neurology that is relevant to AAN interests or activities. Dr. Lazaridis has nothing to disclose. Dr. Bulwa has nothing to disclose. Dr. Alvarado Dyer has nothing to disclose. Dr. Saleh Velez has nothing to disclose. Dr. Prabhakaran has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. The institution of Dr. Prabhakaran has received research support from NIH . Dr. Prabhakaran has received publishing royalties from a publication relating to health care. Dr. Batra has nothing to disclose. Dr. Stamm has nothing to disclose. Dr. Reish has nothing to disclose. Dr. Ruland has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Up to Date. Dr. Ruland has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Law Firms. Michael Teitcher, MD has nothing to disclose. Dr. Taylor has nothing to disclose. Dr. Conners has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for arena pharmaceuticals. The institution of Dr. Conners has received research support from nih. Dr. Liotta has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Penumbra. The institution of Dr. Liotta has received research support from NIH-NINDS. Dr. Grewal has nothing to disclose. Dr. Pinna has nothing to disclose. Dr. Dafer has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Dafer has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eli Lilly. Dr. Dafer has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Anderson, Rasor, and partners. Dr. Da Silva has nothing to disclose. Dr. Hall has nothing to disclose. Dr. John has received personal compensation for serving as an employee of Gift of Hope. Theresa Terna has nothing to disclose. Dr. Shafi has nothing to disclose. Dr. Miller has nothing to disclose. Dr. Moustafa has nothing to disclose. Dr. Vargas has nothing to disclose. Dr. Gorelick has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer. Dr. Gorelick has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AstraZeneca. Dr. Gorelick has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AbbVie. Dr. Gorelick has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AMGEN. Dr. Gorelick has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Gorelick has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi-Genzyme. Dr. Gorelick has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Thorek Memorial Hospital. Dr. Gorelick has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Thorek Memorial Hospital. Dr. Testai has nothing to disclose.