Significant Mortality Associated With COVID-19 and Comorbid Cerebrovascular Disease: A Quantitative Systematic Review

Authors

Tolga Sursal, From the Brain and Spine Institute at Westchester Medical Center, Valhalla, NY 10595.
Chirag D. Gandhi, From the Brain and Spine Institute at Westchester Medical Center, Valhalla, NY 10595.
Kevin Clare, New York Medical College, Valhalla, NY.
Eric Feldstein, From the Brain and Spine Institute at Westchester Medical Center, Valhalla, NY 10595.
Ilya Frid, From the Brain and Spine Institute at Westchester Medical Center, Valhalla, NY 10595.
Martin Kefina, From the Brain and Spine Institute at Westchester Medical Center, Valhalla, NY 10595.
Daniela Galluzzo, From the Brain and Spine Institute at Westchester Medical Center, Valhalla, NY 10595.
Haris Kamal, From the Brain and Spine Institute at Westchester Medical Center, Valhalla, NY 10595.
Rolla Nuoman, From the Brain and Spine Institute at Westchester Medical Center, Valhalla, NY 10595.
Krishna Amuluru, Neurointerventional Radiology, Goodman Campbell Brain and Spine at Ascension St. Vincent, Indianapolis, IN.
Carrie R. Muh, From the Brain and Spine Institute at Westchester Medical Center, Valhalla, NY 10595.
Jared M. Pisapia, From the Brain and Spine Institute at Westchester Medical Center, Valhalla, NY 10595.
Edwin Gulko, From the Brain and Spine Institute at Westchester Medical Center, Valhalla, NY 10595.
Philip Overby, From the Brain and Spine Institute at Westchester Medical Center, Valhalla, NY 10595.
Dipak Chandy, From the Brain and Spine Institute at Westchester Medical Center, Valhalla, NY 10595.
Mill Etienne, From the Brain and Spine Institute at Westchester Medical Center, Valhalla, NY 10595.
Christeena Kurian, From the Brain and Spine Institute at Westchester Medical Center, Valhalla, NY 10595.
Gurmeen Kaur, From the Brain and Spine Institute at Westchester Medical Center, Valhalla, NY 10595.
Katarina Dakay, From the Brain and Spine Institute at Westchester Medical Center, Valhalla, NY 10595.
May AlHamid, Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada.
Hosam Al-Jehani, Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada.
Stephan A. Mayer, From the Brain and Spine Institute at Westchester Medical Center, Valhalla, NY 10595.
Fawaz Al-Mufti, From the Brain and Spine Institute at Westchester Medical Center, Valhalla, NY 10595.Follow

Author Type(s)

Faculty, Student, Resident/Fellow

Journal Title

Cardiology in Review

First Page

199

Last Page

206

Document Type

Article

Publication Date

7-1-2023

Department

Neurosurgery

Second Department

Pediatrics

Third Department

Radiology

Abstract

We report the first quantitative systematic review of cerebrovascular disease in coronavirus disease 2019 (COVID-19) to provide occurrence rates and associated mortality. Through a comprehensive search of PubMed we identified 8 cohort studies, 5 case series, and 2 case reports of acute cerebrovascular disease in patients with confirmed COVID-19 diagnosis. Our first meta-analysis utilizing the identified publications focused on comorbid cerebrovascular disease in recovered and deceased patients with COVID-19. We performed 3 additional meta-analyses of proportions to produce point estimates of the mortality and incidence of acute cerebrovascular disease in COVID-19 patients. Patient's with COVID-19 who died were 12.6 times more likely to have a history of cerebrovascular disease. We estimated an occurrence rate of 2.6% (95% confidence interval, 1.2-5.4%) for acute cerebrovascular disease among consecutively admitted patients with COVID-19. While for those with severe COVID-19' we estimated an occurrence rate of 6.5% (95% confidence interval, 4.4-9.6%). Our analysis estimated a rate of 35.5% for in-hospital mortality among COVID-19 patients with concomitant acute cerebrovascular disease. This was consistent with a mortality rate of 34.0% which we obtained through an individual patient analysis of 47 patients derived from all available case reports and case series. COVID-19 patients with either acute or chronic cerebrovascular disease have a high mortality rate with higher occurrence of cerebrovascular disease in patients with severe COVID-19.

Recommended Citation

Sursal, T., Gandhi, C. D., Clare, K., Feldstein, E., Frid, I., Kefina, M., Galluzzo, D., Kamal, H., Nuoman, R., Amuluru, K., Muh, C. R., Pisapia, J. M., Gulko, E., Overby, P., Chandy, D., Etienne, M., Kurian, C., Kaur, G., Dakay, K., AlHamid, M., Al-Jehani, H., Mayer, S. A., & Al-Mufti, F. (2023). Significant Mortality Associated With COVID-19 and Comorbid Cerebrovascular Disease: A Quantitative Systematic Review. Cardiology in Review, 31 (4), 199-206. https://doi.org/10.1097/CRD.0000000000000480