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 inflammatory 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 elevated IBMs in the prediction of ischemic COVID-stroke.

Materials and methods

Clinical characteristics, stroke risk factors, laboratory parameters- including levels of inflammatory biomarkers, and outcome of SARS-CoV2 patients with stroke (n=60) were collected. SARS-CoV2 RT- PCR positive age, gender, and pulmonary 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 > 441.8 ng/mL, LDH> 395U/L, ESR >19 mm/h and CRP> 0.2 mg/dL were independently found to be very strong predictors of occurrence of ischemic COVID-stroke (p < 0.001 for each). On multivariate 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 mellitus, 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.

中文翻译：

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炎症生物标志物水平升高是否可以预测 SARS-CoV2 中发生缺血性中风的风险？：一项观察性研究

介绍

据报道，0.9% 至 5% 的 SARS-CoV2 患者中风是 SARS-CoV2 的一种可怕并发症。有人担心 SARS-CoV2 感染与急性缺血性卒中有显着的独立关联，即使在没有传统脑血管危险因素的情况下也是如此。炎症生物标志物水平升高是否对 SARS-CoV2 中风的发生具有预测价值尚不清楚。

目的

分析 SARS-CoV2 阳性缺血性中风（COVID-Stroke）患者的特征，并确定升高的 IBMs 在预测缺血性 COVID-stroke 中的意义。

材料和方法

收集了 SARS-CoV2 中风患者 (n=60) 的临床特征、中风危险因素、实验室参数（包括炎症生物标志物水平）和结果。将 SARS-CoV2 RT-PCR 阳性、年龄、性别和肺部严重程度匹配的非卒中患者作为对照（n  = 60）。使用二元多变量逻辑回归分析来寻找缺血性 COVID-中风的预测因子。

结果

D-二聚体 > 441.8 ng/mL、LDH> 395U/L、ESR >19 mm/h 和 CRP > 0.2 mg/dL 被独立发现是发生缺血性 COVID-stroke 的非常强的预测因子（每个p  < 0.001） . 在多变量分析中，发现 D-二聚体 > 441.8 ng/mL、ESR > 19 mm/h 和 RDW > 16.1% 是发生缺血性 COVID-stroke 的最强预测因子。传统的 CVD 危险因素——高龄（> 60 岁）、糖尿病和高血压在多变量分析中未被发现是显着的预测因子。

结论

在 SARS-CoV2 患者中，D-二聚体升高超过 441.8 ng/mL、ESR 大于 19 mm/h 和 RDW 扩大超过 16.1% 是发生缺血性中风的最强预测因子。这是第一项试图在预测缺血性 COVID-stroke 中找到 IBM 临界值的研究。