Association between SARS-CoV-2 and Stroke: Perspectives from a metaumbrella-review

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Abstract

In the face of the global COVID-19 pandemic, the need arose to investigate potential complications associated with SARS-CoV-2, including the risk of Stroke.

Objective

This study aimed to verify the association between SARS-CoV-2 and the risk of Stroke, based on systematic reviews and meta-analyses, in order to assess the inclusion of the virus as a new risk factor for cerebrovascular diseases.

Methods

A metaumbrella was conducted, which included 34 systematic reviews, of which 4 were selected for the final analysis based on methodological quality and consistency. The analysis aggregated the results of 70 primary studies, considering different stroke subtypes and outcomes associated with COVID-19. Study heterogeneity was assessed using the I² index, and significance bias was verified using Egger’s test.

Results

The analysis showed that the severity of COVID-19 is significantly associated with an increased risk of stroke (eOR = 2.48; 95%CI: 1.55 – 3.95), particularly for ischemic stroke (eOR = 1.76; 95%CI: 1.11 – 2.80) and hemorrhagic stroke (eOR = 3.86; 95%CI: 1.79 – 8.33). Additionally, patients with cerebrovascular comorbidities had higher mortality (eOR = 2.48; 95%CI: 2.48 – 19.63), as did those who had previously suffered a stroke (eOR = 6.08; 95%CI: 3.73 – 9.91).

Conclusion

The association between SARS-CoV-2 and stroke was consistent and significant, suggesting that COVID-19 should be considered a new risk factor for cerebrovascular diseases. However, the high heterogeneity among the studies analyzed reinforces the need for further research to consolidate this relationship.

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