Incidence of Stroke in Randomized Trials of COVID-19 Therapeutics: A Systematic Review and Meta-Analysis

BACKGROUNDCOVID-19 has been frequently associated with an increased risk of thrombotic complications. There have also been reports of an increased likelihood of stroke, although its true incidence in patients with COVID-19 is currently unknown. METHODSElectronic databases PubMed and Scopus were sear...

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Veröffentlicht in:Stroke (1970) 2022-11, Vol.53 (11), p.3410-3418
Hauptverfasser: Nagraj, Sanjana, Varrias, Dimitrios, Hernandez Romero, Gabriel, Santos, Heitor T., Karamanis, Dimitrios, Sagris, Dimitrios, Korompoki, Eleni, Milionis, Haralampos, Palaiodimos, Leonidas, Ntaios, George
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Sprache:eng
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Zusammenfassung:BACKGROUNDCOVID-19 has been frequently associated with an increased risk of thrombotic complications. There have also been reports of an increased likelihood of stroke, although its true incidence in patients with COVID-19 is currently unknown. METHODSElectronic databases PubMed and Scopus were searched from inception up to July 30, 2021 to identify randomized controlled studies in patients with confirmed COVID-19 undergoing one or more interventions. Studies were screened for eligibility using a predefined inclusion criterion and selected using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A random-effects model meta-analysis was conducted, and heterogeneity was assessed using I-squared test. RESULTSOut of 3960 potentially eligible articles, 77 randomized studies (38 732 patients) were included. Mean age of the study population was 55±9.3 years. Females constituted 38% of the study population and mean duration of follow-up after study enrollment was 23±12.9 days. Cumulative incidence of stroke in the overall study population was 0.001 (95% CI, 0.001-0.002) with a total of 65 events in 38 732 patients, corresponding to an absolute incidence of 0.168%. Incidence of stroke in the inpatient population was 0.001 (95% CI, 0.001-0.002; 65 events in 37 069 patients), corresponding to an absolute incidence of 0.175%. No strokes were observed in the outpatient setting. CONCLUSIONSThe overall incidence of stroke in patients with COVID-19 appears to be lower than that reported in previous observational reports.
ISSN:0039-2499
1524-4628
DOI:10.1161/STROKEAHA.122.040233