Clinical features and outcome of stroke with COVID-19. COVID-19 stroke study group (CSSG), India Rohit Bhatia1, MV Padma Srivastava1, PN Sylaja2, Snigdha Komakula1, Ashish Upadhyay3, Vibhor Pardasani4, Thomas Iype5, Rajsrinivas Parthasarathy6, Rajshekhar Reddy7, Suman Kushwaha8, Jayanta Roy9, P Satish1, Anjan Trikha10, Naveet Wig11, Lalit Dhar12, Deepti Vibha1, Venugopalan Y Vishnu1, Awadh Kishore Pandit1, Anu Gupta1, A Elavarasi1, Ayush Agarwal1, Vipul Gupta13, Rakesh K Singh4, Harsh Oza4, Hiral Halani4, Dileep Ramachandran5, Githin B George5, Praveen Panicker5, MK Suresh5, S Kumaravelu14, Dheeraj Khurana15, Srijithesh P Rajendran16, Vijaya Pamidimukkala17, Salil Gupta18, Jeyaraj D Pandian19, Debashish Chowdhury20, Nirendra K Rai21, Arvind Sharma22, Vivek K Nambiar23


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Clinical features and outcome of stroke with COVID-19. COVID-19 stroke study group (CSSG), India Rohit Bhatia¹, MV Padma Srivastava¹, PN Sylaja², Snigdha Komakula¹, Ashish Upadhyay³, Vibhor Pardasani⁴, Thomas Iype⁵, Rajsrinivas Parthasarathy⁶, Rajshekhar Reddy⁷, Suman Kushwaha⁸, Jayanta Roy⁹, P Satish¹, Anjan Trikha¹⁰, Naveet Wig¹¹, Lalit Dhar¹², Deepti Vibha¹, Venugopalan Y Vishnu¹, Awadh Kishore Pandit¹, Anu Gupta¹, A Elavarasi¹, Ayush Agarwal¹, Vipul Gupta¹³, Rakesh K Singh⁴, Harsh Oza⁴, Hiral Halani⁴, Dileep Ramachandran⁵, Githin B George⁵, Praveen Panicker⁵, MK Suresh⁵, S Kumaravelu¹⁴, Dheeraj Khurana¹⁵, Srijithesh P Rajendran¹⁶, Vijaya Pamidimukkala¹⁷, Salil Gupta¹⁸, Jeyaraj D Pandian¹⁹, Debashish Chowdhury²⁰, Nirendra K Rai²¹, Arvind Sharma²², Vivek K Nambiar²³ ¹ Department of Neurology, All India Institute of Medical Sciences, New Delhi, India ² Department of Neurology, Sree Chitra Thirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India ³ Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India ⁴ Department of Neurology, Bombay Hospital and Medical Research Centre, Mumbai, Maharashtra, India ⁵ Department of Neurology, Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, India ⁶ Department of Neurology; Department of Neurointervention Surgery, Artemis Hospitals, Gurgaon, Haryana, India ⁷ Department of Neurology, Max Super Speciality Hospital Saket, New Delhi, India ⁸ Department of Neurology, Institute of Human Behaviour and Allied Sciences, Neurology, New Delhi, India ⁹ Department of Neurology, Institute of Neurosciences, Kolkata, West Bengal, India ¹⁰ Department of Anaesthesia, All India Institute of Medical Sciences, New Delhi, India ¹¹ Department of Medicine, All India Institute of Medical Sciences, New Delhi, India ¹² Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India ¹³ Department of Neurointervention Surgery, Artemis Hospitals, Gurgaon, Haryana, India ¹⁴ Department of Neurology, Ramesh Hospitals Guntur, Andhra Pradesh, India ¹⁵ Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India ¹⁶ Department of Neurology, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India ¹⁷ Department of Neurology, Lalitha Super Specialty Hospital, Guntur, Andhra Pradesh, India ¹⁸ Department of Neurology, Command Hospital Air Force Bangalore, Bangalore, Karnataka, India ¹⁹ Department of Neurology, Christian Medical College, Ludhiana, Punjab, India ²⁰ Department of Neurology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, Delhi, India ²¹ Department of Neurology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India ²² Department of Neurology, Zydus Hospital, Ahmedabad, Gujarat, India ²³ Department of Neurology, Amrita Institute of Medical Sciences, Cochin, Kerala, India Correspondence Address: Rohit Bhatia, Department of Neurology, All India Institute of Medical Sciences, New Delhi India Source of Support: None, Conflict of Interest: None DOI: 10.4103/aian.AIAN_122_21

Background and Purpose: Occurrence of stroke has been reported among patients with COVID-19. The present study compares clinical features and outcomes of stroke patients with and without COVID-19. Methods: The COVID-19 Stroke Study Group (CSSG) is a multicentric study in 18 sites across India to observe and compare the clinical characteristics of patients with stroke admitted during the current pandemic period and a similar epoch in 2019. The present study reports patients of stroke with and without COVID-19 (CoVS and non-CoVS, respectively) seen between February 2020 and July 2020. Demographic, clinical, treatment, and outcome details of patients were collected. Results: The mean age and gender were comparable between the two groups. CoVS patients had higher stroke severity and extent of cerebral involvement on imaging. In-hospital complications and death were higher among CoVS patients (53.06% vs. 17.51%; P < 0.001) and (42.31% vs. 7.6%; P < 0.001), respectively. At 3 months, higher mortality was observed among CoVS patients (67.65% vs. 13.43%; P < 0.001) and good outcome (modified Rankin score [mRS]: 0–2) was seen more often in non-CoVS patients (68.86% vs. 33.33%; P < 0.001). The presence of COVID-19 and baseline stroke severity were independent predictors of mortality. Conclusions: CoVS is associated with higher severity, poor outcome, and increased mortality. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and baseline stroke severity are independent predictors of mortality.

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    -  Bhatia R
    -  Padma Srivastava M V
    -  Sylaja P N
    -  Komakula S
    -  Upadhyay A
    -  Pardasani V
    -  Iype T
    -  Parthasarathy R
    -  Reddy R
    -  Kushwaha S
    -  Roy J
    -  Satish P
    -  Trikha A
    -  Wig N
    -  Dhar L
    -  Vibha D
    -  Vishnu VY
    -  Pandit AK
    -  Gupta A
    -  Elavarasi A
    -  Agarwal A
    -  Gupta V
    -  Singh RK
    -  Oza H
    -  Halani H
    -  Ramachandran D
    -  George GB
    -  Panicker P
    -  Suresh M K
    -  Kumaravelu S
    -  Khurana D
    -  Rajendran SP
    -  Pamidimukkala V
    -  Gupta S
    -  Pandian JD
    -  Chowdhury D
    -  Rai NK
    -  Sharma A
    -  Nambiar VK

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