Prevalence of symptomatic acute cerebral infarction among patients with COVID-19 and D-dimer as a predictor of cerebral infarction

Objectives: This study sought to investigate the frequency of symptomatic acute cerebral infarction (sACI) among patients with novel coronavirus (COVID-19) disease and the predictive value of laboratory parameters such as D-dimer and neutrophil-to-lymphocyte ratio (NLR) in sACI. Methods: This retrospective case-control study analyzed the data of 2,378 patients with COVID-19 registered in our database between April 1, 2020 and November 30, 2020. Of these patients, a total of 119 subjects were included in the study, including 31 COVID-19 patients with sACI (patient group) and 88 randomly selected COVID-19 patients without sACI (control group). Categorical variables were compared using Chi-square test and predictive value of the variables was analyzed using receiver operating characteristics (ROC) curve analysis. Results: Thirty one (1.30%) of 2,378 COVID-19 patients had sACI. Mann-Whitney U test showed that median D-dimer, neutrophil and NLR values were significantly higher in the sACI group compared to the control group (p = 0.004, p < 0.048 and p = 0.007, respectively). ROC analysis yielded the following areas under the ROC curve: D-dimer = 0.674 (95% CI, 0.569-0.779), NLR = 0.663 (95% CI, 0.559-0.767) and neutrophils = 0.620 (95% CI, 0.509-0.73). Conclusion: The results of the present study showed that elevated D-dimer levels can be used as a predictor of sACI in COVID-19 patients.