A NEW meta-analysis has revealed a significant association between COVID-19 and an increased risk of stroke, suggesting that the virus should be considered as a new risk factor for cerebrovascular diseases.
The researchers conducted a metaumbrella comprising 34 systematic analyses and 70 primary studies to investigate the associations between COVID-19 and stroke. The geographical coverage of included studies was high, encompassing the USA, Italy, India, Spain, Brazil, and, most extensively, China.
Results showed that patients with severe COVID-19 were more than twice as likely to suffer a stroke (odds ratio equivalent [eOR]: 2.48; 95% CI: 1.55– 3.95). The risk was notably high for ischaemic stroke (eOR: 1.76; 95% CI: 1.11–2.80) and even more pronounced for haemorrhagic stroke (eOR: 3.86, 95% CI: 1.79–8.33). Patients with pre-existing cerebrovascular comorbidities also showed increased mortality rates (eOR: 2.48), with the odds significantly higher in those who had experienced a previous stroke (eOR: 6.08, 95% CI: 3.73–9.91).
However, significant heterogeneity was observed across many studies, suggesting variability in the results (I² values > 50% in some cases). The authors emphasised that, while the association between SARS-CoV-2 and stroke appears robust, the high variability between studies and small sample size highlight the need for further research to refine these associations, and guide future prevention and treatment strategies.
Ada Enesco, EMJ
Reference
De Souza AML et al. Association between SARS-CoV-2 and stroke: perspectives from a metaumbrella-review. medRxiv. 2024; DOI: 10.1101/2024.10.01.24314742.
