Stroke more common among Black COVID-19 patients
Black COVID-19 patients face a risk of ischemic stroke approximately three times as high as other patients, according to new data published in the Journal of Stroke and Cerebrovascular Diseases.
While the rate of cerebrovascular disease is high in patients with a confirmed COVID-19 diagnosis, little research has been done to examine whether racial disparities exist, the authors explained. They explored U.S. emergency department (ED) data to find out.
“There is uncertainty about the end of the COVID-19 pandemic and its long-term effects on chronic conditions such as stroke, including racial/ethnic disparity in stroke occurrence” wrote first author Alain Lekoubou, MD, with the department of neurology at Penn State University, and colleagues. “This uncertainty further brings to focus the need to reduce disparity between races/ethnicities. We tested the hypothesis that among COVID-19 patients visiting the ED in the US, racial disparities in the prevalence of ischemic stroke persisted.
All patients included in the analysis were registered in the COVID-19 Research Database between 2019 and 2020. The database is a public-private consortium that allows public health and policy researchers to utilize real-world data to gain insight and battle the COVID-19 pandemic.
The study’s authors evaluated 8,815 adult ED patients who tested positive for COVID-19.
Of that group of patients, 34% were Black, 30% were non-Hispanic white and 36% were Hispanic.
A total of 77 (0.87%) patients were diagnosed with acute ischemic stroke. Fifty-seven percent of those patients were women. The mean patient age was 64 years old.
Of those 77 patients, 50% were Black, 29% were non-Hispanic white and 21% were Hispanic. After controlling for multiple factors, the authors determined that Black patients faced a stroke risk that was three times greater than other patients.
In addition, stroke rates also tended to be higher in southern states compared with other parts of the United States.
"Our findings are of great importance since stroke is a known risk factor of mortality in patients with COVID-19," the authors wrote.
Lekoubou et al. also noted that their study had limitations.
“Although we found an association between race and stroke rate in COVID-19 patients, we could not established causality," they wrote. "Unmeasured confounders could mask the true link between stroke and race/ethnicity in COVID-19 patients. The database did not provide granular data such as the stroke type, mechanisms of stroke, etiologies of stroke, disease severity variables and blood coagulation parameters."
The authors also suggested that some of the disparities they identified may be attributed to the racial mixture of the study's population "and are likely very dependent on the higher proportion of Blacks in the COVID-19 population."
Read the full study here.