Background and purpose Coronavirus disease 2019 (COVID-19) is associated with a small but clinically significant risk of stroke, the cause of which is frequently cryptogenic. In a large multinational cohort of consecutive COVID-19 patients with stroke, we evaluated clinical predictors of cryptogenic stroke, short-term functional outcomes and in-hospital mortality among patients according to stroke etiology. Methods We explored clinical characteristics and short-term outcomes of consecutively evaluated patients 18 years of age or older with acute ischemic stroke (AIS) and laboratory-confirmed COVID-19 from 31 hospitals in 4 countries (3/1/20–6/16/20). Results Of the 14.483 laboratory-confirmed patients with COVID-19, 156 (1.1%) were diagnosed with AIS. Sixty-one (39.4%) were female, 84 (67.2%) white, and 88 (61.5%) were between 60 and 79 years of age. The most frequently reported etiology of AIS was cryptogenic (55/129, 42.6%), which was associated with significantly higher white blood cell count, c-reactive protein, and D-dimer levels than non-cryptogenic AIS patients (p=0.05 for all comparisons). In a multivariable backward stepwise regression model estimating the odds of in-hospital mortality, cryptogenic stroke mechanism was associated with a fivefold greater odds in-hospital mortality than strokes due to any other mechanism (adjusted OR 5.16, 95%CI 1.41–18.87, p = 0.01). In that model, older age (aOR 2.05 per decade, 95%CI 1.35–3.11, p < 0.01) and higher baseline NIHSS (aOR 1.12, 95%CI 1.02–1.21, p = 0.01) were also independently predictive of mortality. Conclusions Our findings suggest that cryptogenic stroke among COVID-19 patients carries a significant risk of early mortality. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02075-1.
【저자키워드】 COVID-19, coronavirus, Mortality, stroke, Cryptogenic, 【초록키워드】 Coronavirus disease 2019, Clinical characteristics, hospital, risk, outcome, Protein, Cohort, White blood cell, Regression model, female, Patient, Older age, age, predictor, etiology, mechanism, in-hospital mortality, D-dimer level, COVID-19 patient, Predictive, Older, supplementary material, 95%CI, Comparisons, laboratory-confirmed, country, multivariable, Result, greater, reported, clinically, diagnosed, evaluated, adjusted, functional, significantly higher, AIS, baseline, patients with COVID-19, 【제목키워드】 Patient, etiology,