Scoring system could predict stroke in people hospitalized for COVID-19

By American Heart Association News

Flavio Coelho/Moment, Getty Images
(Flavio Coelho/Moment, Getty Images)

A new scoring system based on a person's medical data may help predict who is at higher risk for having a stroke when hospitalized with COVID-19, preliminary new research shows.

The scoring system – which was as effective at predicting stroke risk as computer models – found people with four or more risk factors related to their medical history and condition at the time of hospital admission were 10 times more likely to have a stroke as those with fewer risk factors. The findings, considered preliminary until a full paper is published in a peer-reviewed journal, are being presented this week at the American Stroke Association's International Stroke Conference.

Identifying patients with higher stroke risk could help medical professionals "monitor them more closely and provide treatment more quickly," lead study author Dr. Alexander E. Merkler said in a news release. He is an assistant professor of neurology at Weill Cornell Medical College and an assistant attending neurologist at New York-Presbyterian Hospital in New York City.

"Future research could focus on specific treatments that may benefit people with COVID-19 who are at higher risk for stroke," he said.

The scoring system was developed using the American Heart Association's COVID-19 registry, a nationwide database that includes medical and demographic information about people hospitalized for COVID-19, their treatment and cardiovascular risk factors. As of Dec. 7, the registry included more than 63,000 patient records from 170 registry sites.

Researchers analyzed data for 21,420 adults hospitalized for COVID-19 at 122 U.S. health centers for a full year beginning in March 2020. Overall, 1 in 65 hospitalized adults had a stroke. The patients' average age was 61.

They identified six factors that helped predict who was at highest risk for stroke: a previous stroke; not having a fever; no history of lung disease; a high white blood cell count; high blood pressure; and elevated systolic blood pressure, which is the top number in a blood pressure reading that measures the force the heart exerts each time it beats.

"Of the six factors linked to increased risk of stroke, one was 'no history of pulmonary disease' and another was 'no fever,'" Merkler said. "This seemed a bit surprising because patients with lung disease and those with high fever are at higher risk to develop severe COVID-19."

Those who had at least four of the six factors were 10 times more likely to have a stroke as those who had fewer risk factors. They got the same results using an artificial intelligence-based computer model to predict the patients' stroke risk.

Stroke is the fifth-leading cause of death in the U.S. As the pandemic continues, researchers say evidence is emerging that COVID-19 may increase the risk for stroke and poor outcomes.

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