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Cerebrovascular disease history ups mortality risk in COVID-19 patients

20 Sep 2020

A history of cerebrovascular disease increases the risk of mortality in patients with the novel coronavirus disease (COVID-19) by 2.78-fold when compared to those with other comorbidities or without underlying pathologies, reveal the results of a recent study.

The investigators performed a systematic review according to the PRISMA guidelines using the following databases: PubMed, Scopus, Embase, Medline, Lilacs, Science Direct, and EBSCO Host. Studies involving patients with a diagnosis of COVID-19 and a history of stroke were eligible for analysis.

Risk of bias was assessed using the Newcastle-Ottawa Scale, and experimental studies were evaluated using the ROBINS-I scale.

A total of 213 articles were identified, of which only seven met the eligibility criteria. Overall, 3,244 patients with COVID-19 were involved, of whom 198 had a history of cerebrovascular disease.

The meta-analysis of data revealed an increase in mortality among COVID-19 patients with a history of cerebrovascular disease (odds ratio, 2.78, 95 percent confidence interval, 1.42–5.46; p=0.007; I2, 49 percent) as compared to those with different comorbidities or those without underlying pathology.

Adequate heterogeneity was shown. In addition, an Egger test in a funnel plot was used to assess the presence of publication bias. Asymmetry was observed, indicating no publication bias. However, the presence of bias could neither be ruled out nor confirmed due to the low number of included studies.

“History of stroke has been associated with an increased risk of a new ischaemic stroke,” the investigators noted. “Several studies have indicated increased prevalence of strokes among coronavirus patients.”

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