2020
DOI: 10.1016/j.clineuro.2020.106183
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Relationship between the history of cerebrovascular disease and mortality in COVID-19 patients: A systematic review and meta-analysis

Abstract: Highlights Cerebrovascular disease as a risk factor for COVID-19 mortality. Future studies will allow the development of risk scales in patients with COD19 and a history of stroke. More clinical trials are need to explore the effect of history of stroke and COVID19.

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Cited by 12 publications
(8 citation statements)
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“…In this cohort, the majority of patients with a prior cerebrovascular disease had a prior acute ischemic stroke (9.9%; 11/1,128), a prevalence which was higher than expected from U.S. 2013–2016 stroke estimates of 2.5% for adults ages > 20 years old ( 14 ). These results are consistent with published cohorts suggesting a greater number of hospitalized COVID-19 patients with cerebrovascular disease than prevalence estimates and increased likelihood of negative outcomes ( 4 , 8 , 10 13 , 16 , 17 , 21 , 28 31 ). The findings presented here extends our understanding of comorbidities that may contribute to increased risk of critical illness in COVID-19, and additionally suggests that critically ill COVID-19 patients with cerebrovascular disease may be prone to longer mechanical ventilation time than patients of similar ages and demographics without cerebrovascular disease.…”
Section: Discussionsupporting
confidence: 91%
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“…In this cohort, the majority of patients with a prior cerebrovascular disease had a prior acute ischemic stroke (9.9%; 11/1,128), a prevalence which was higher than expected from U.S. 2013–2016 stroke estimates of 2.5% for adults ages > 20 years old ( 14 ). These results are consistent with published cohorts suggesting a greater number of hospitalized COVID-19 patients with cerebrovascular disease than prevalence estimates and increased likelihood of negative outcomes ( 4 , 8 , 10 13 , 16 , 17 , 21 , 28 31 ). The findings presented here extends our understanding of comorbidities that may contribute to increased risk of critical illness in COVID-19, and additionally suggests that critically ill COVID-19 patients with cerebrovascular disease may be prone to longer mechanical ventilation time than patients of similar ages and demographics without cerebrovascular disease.…”
Section: Discussionsupporting
confidence: 91%
“…Our understanding of the risk of COVID-19 critical illness due to chronic neurological conditions remains limited, with cohorts from Asia and Europe suggesting a history of ischemic or hemorrhagic stroke as risk factors for severe events such as mechanical ventilation (MV) ( 8 ) and death ( 8 , 10 ). Recently, two meta-analyses reviewed the relationship between the prior cerebrovascular disease and in-hospital outcomes in COVID-19, using data derived from Chinese and European cohorts, and suggested an increase in risk for critical illness ( 16 ) and mortality ( 17 ) among patients with prior cerebrovascular disease.…”
Section: Introductionmentioning
confidence: 99%
“…The baseline characteristics associated with mortality observed in this study were in line with the findings of other studies, such as a higher proportion of deaths in older patients, higher Charlson comorbidity index value, and history of stroke 3 , 9 - 10 . We also found a higher proportion of deaths in patients who lived in nursing homes (60%), in accordance with studies carried out in Brazil and other countries, which highlighted the high vulnerability of patients residing in nursing homes 11 .…”
supporting
confidence: 91%
“…Nine reviews which were rated as moderate quality examined associations between cerebrovascular disease and outcomes with COVID-19. 21 , 23 , 25 , 31 , 38 , 39 , 44 , 46 , 48 The moderate quality review with the largest number of studies reported cerebrovascular disease was associated with a significant 2.75 times higher risk of mortality [pooled relative risk (RR) 2.75 (1.54–4.89), n = 11 studies, considerable heterogeneity ( I 2 = 99%)]. 39 The review by Fang et al ., 23 was also rated moderate quality and included the largest number of studies examining the association between cerebrovascular disease and severe COVID-19.…”
Section: Resultsmentioning
confidence: 99%