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Abstract Details

Ischemic Stroke In Covid-19: A Need For Early Identification And Management
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
012
We aimed to describe the clinical and radiographic characteristics of patients who were admitted with COVID-19 and had an acute ischemic stroke.
In the setting of the Coronavirus Disease 2019 (COVID-19) global pandemic caused by SARS-CoV-2, a potential association of this disease with stroke has been suggested. 

This is a case series of PCR-confirmed COVID-19 patients with ischemic stroke admitted to an academic health system in Atlanta, Georgia (USA) between March 24th , 2020 and July 17th , 2020. Demographic, clinical, and radiographic characteristics were described. 
Of 396 ischemic stroke patients admitted during this study period, 13 (2.5%) were also diagnosed with COVID-19. The mean age of patients was 61.6 ± 10.8 years, 10 (76.9%) male, 8 (61.5%) were Black Americans, mean time from last normal was 4.97 ± 5.1 days, and only one received acute reperfusion therapy. All 13 patients had at least one stroke-associated co-morbidity. The predominant pattern of ischemic stroke was embolic with 4 explained by atrial fibrillation. COVID-19 patients had a significantly higher rate of cryptogenic stroke than non-COVID-19 patients during the study period (69% vs 17%, p=0.0001). 4 patients (30.7%) died by the end of the study period. 
In our case series, ischemic stroke affected COVID-19 patients with traditional stroke risk factors, but mainly affecting males and Black Americans. We observed a predominantly embolic pattern of stroke with a higher than expected rate of cryptogenic strokes, a prolonged median time to presentation and symptom recognition limiting the use of acute reperfusion treatments along with a high mortality. These results highlight the need for increased community awareness, early identification, and management of AIS in COVID-19 patients. Further studies to determine the effects of COVID-19 associated coagulopathy on ischemic stroke risk as well as the interactions between COVID-19 and other known stroke risk factors are warranted.
Authors/Disclosures
Nicholas Janocko, MD (Weill Cornell Neurology)
PRESENTER 		Dr. Janocko has nothing to disclose.
Fadi B. Nahab, MD Dr. Nahab has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Legal Consultation. Dr. Nahab has received intellectual property interests from a discovery or technology relating to health care.
Srikant Rangaraju, MBBS (Emory University, Atlanta) Dr. Rangaraju has nothing to disclose.
Karima Benameur, MD (Emory University) Dr. Benameur has nothing to disclose.
James Greene, MD, PhD (Emory University) Dr. Greene has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Medlink Neurology.
Wendy Wright, MD Dr. Wright has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Multiple Law Firms.
No disclosure on file
Dinesh V. Jillella, MD (Emory University School of Medicine / Grady Memorial Hospital) Dr. Jillella has nothing to disclose.