Covid-19 Associated High Mortality Among Patients With Acute Stroke In A University Hospital In Kumasi, Ghana – A Retrospective Study

Abstract

Objectives: The World Stroke Organization (WSO) has raised concerns about the global impact of COVID-19 on occurrence of stroke and its implications for stroke care, especially in low-middle-income countries. We sought to describe the profile and outcomes of acute stroke admissions in relation to COVID-19 status.
 Methodology: This is a retrospective study involving all stroke patients admitted to the University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana from 1st March, 2020 to 30th November, 2020. Stroke was diagnosed clinically and confirmed with a head Computerized Tomography scan. After the diagnosis of stroke, all patients with presentations that fitted the case definition of COVID-19 were tested using real time polymerase chain reaction (RT-PCR). Bivariate analysis was performed to identify factors associated with in-patient mortality. Statistical significance level was set at p < 0.05.
 Results: A total of 93 patients with confirmed acute stroke were hospitalized within a 9-month period with 3 (3.2%) having confirmed COVID-19 infection. All COVID-19 cases had ischemic stroke and all of them died. Bivariate analyses identified COVID-19 status (p=0.016), mean pulse rate (p=0.036) and patients who did not receive angiotensin receptor blocker (ARB) (p=0.029) or calcium channel blockers (CCB) (p=0.016) were associated with in-patient mortality.
 Conclusion: COVID-19 occurring with acute stroke is a predictor of mortality in this sample of Ghanaians. In this era of COVID-19 pandemic, patients with acute stroke should also be screened for the infection and managed appropriately to minimize death.