COVID-19 patients at higher risk of stroke and heart attack: Circulation
Denmark: COVID-19 patients had a higher risk of developing AMI or ischemic stroke, 14 days after confirmed COVID-19 diagnosis, suggests a recent study in the journal Circulation.
Daniel Modin, University of Copenhagen, Copenhagen Denmark, and colleagues assessed the association between COVID-19 infection and the risk of ischemic stroke and AMI during the acute phase of infection using the self-controlled case series method.
For the purpose, the researchers conducted a registry-based study of all patients with a positive test for COVID-19 admitted to Danish hospitals up to July 16, 2020. The investigators identified all patients who were admitted with either a primary or secondary diagnosis of first-ever ischemic stroke or first-ever AMI up to 180 days prior to COVID-19 diagnosis and until July 16, 2020 using International Classification of Diseases, Tenth Revision codes.
The interval of interest was the 14 days following the date of laboratory-confirmed COVID-19 diagnosis. The control interval was the 180 days prior to the COVID-19 diagnosis and until the end of available data collection, excluding the 14-day risk interval. Each subject was used as his or her own control. Incidence ratios were reported. The analysis included a total of 5,119 patients diagnosed with COVID-19.
Key findings of the study include:
- Forty-four patients (0.86%) received a diagnosis of ischemic stroke, and 18 (41%) received this diagnosis during the 14-day risk interval.
- The incidence ratio of ischemic stroke during the risk period compared to the control period was 12.9.
- Seventeen patients (0.33%) received a diagnosis of AMI, and four (23.5%) received this diagnosis during the 14-day risk interval.
- The incidence ratio of AMI during the risk period compared to the control period was 5.9.
"In this registry-based trial, COVID-19 patients had a higher risk of being diagnosed with ischemic stroke or AMI in the 14 days following their laboratory-confirmed COVID-19 diagnosis (risk interval) than they did during the control interval," concluded the authors.
These results might be impacted bu detection bias, as active COVID-19 patients presumably had greater contact with medical system than in during the time when they were in the control period. Greater contact with the medical system alone can lead to increased diagnosis of AMI and ischemic stroke.
The study, "Acute COVID-19 and the Incidence of Ischemic Stroke and Acute Myocardial Infarction," is published in the journal Circulation.
DOI: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.050809
