protective Role of pre-existing cerebrovascular diseases in local spread of COVID-19 infection in Japan

It is proposed that various pre-existing medical conditions, including cerebrovascular diseases, might increase a risk for severity of coronavirus disease 2019 (COVID-19). The cumulative number of COVID-19 cases in Japan is relatively low, therefore the effect by cerebrovascular diseases can be distinct from that in Western countries. We analyzed the relationship between the local number of patients with pre-existing cerebrovascular diseases per population and local prevalence of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Data on SARS-CoV-2 infection and the estimated number of patients who received medical treatment for cerebrovascular diseases in each prefecture were obtained from the official notifications database of Japan. We analyzed the association between the ratio of patients with each disease and the prevalence of SARS-CoV-2 infection. The ratio of patients with cerebrovascular diseases per population showed a significant negative correlation with the prevalence of SARS-CoV-2 infection (Spearman's rank correlation, p < 0.01). The current study suggests that pre-existing cerebrovascular diseases may play a protective role against local spread of SARS-CoV-2 infection, possibly attributed to common use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers.