Do Elevated Levels of Inflammatory Biomarkers Predict the Risk of Occurrence of Ischemic Stroke in SARS-CoV2?: An Observational Study

Introduction: Stroke, a dreaded complication of SARS-CoV2, has been reported in 0.9 to 5% of SARS-CoV2 patients. There are concerns that SARS-CoV2 infection has a significant independent association with acute ischemic stroke, even in the absence of conventional cerebrovascular risk factors. Whether elevated levels of inflamma-tory biomarkers have predictive value in the occurrence of stroke in SARS-CoV2 is poorly understood. Aim: To profile the characteristics of SARS-CoV2 positive patients with ischemic stroke (COVID-Stroke) and to identify the significance of ele-vated IBMs in the prediction of ischemic COVID-stroke. Materials and methods: Clinical characteristics, stroke risk factors, laboratory parameters- includ-ing levels of inflammatory biomarkers, and outcome of SARS-CoV2 patients with stroke (n=60) were collected. SARS-CoV2 RT-PCR positive age, gender, and pul-monary severity matched non-stroke patients were taken as controls (n = 60). Binary multivariate logistic regression analysis was used to find the predictors of ischemic COVID-stroke. Results: D-dimer 0.001 for each). On multivari-ate analysis, D-dimer 441.8 ng/mL, ESR > 19 mm/h, and RDW > 16.1% were found to be the most strong predictors of the occurrence of ischemic COVID-stroke. Conventional CVD risk factors-higher age (> 60years), presence of diabetes melli-tus, and hypertension were not found to be significant predictors in multivariate analysis. Conclusion: In SARS-CoV2 patients, D-dimer elevated beyond 441.8 ng/ mL, ESR greater than 19 mm/h, and RDW widened more than 16.1% were the strongest predictors of the occurrence of ischemic stroke. This is the first study that attempts to find cut-off levels of IBMs in the prediction of ischemic COVID-stroke.

Automated summary

This study aimed to analyze the factors associated with the occurrence of stroke in SARS-CoV2 patients, finding that elevated levels of D-dimer, erythrocyte sedimentation rate (ESR), and red cell distribution width (RDW) were significantly associated with stroke occurrence, while traditional cardiovascular disease risk factors were not strong predictors of stroke.