Ischemic stroke in COVID-19: An urgent need for early identification and management

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Abstract

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  1. SciScore for 10.1101/2020.05.25.20111047: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The Institutional Review Board of Emory University approved this retrospective study.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.


    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Of note, a recent study from the New York Healthcare System also reported a high prevalence of cryptogenic strokes and suggested a possible association with hypercoagulability (9), although further prospective studies are needed to confirm these findings considering the limitations of retrospective studies. One patient had a prior diagnosis of atrial fibrillation while two had new diagnoses of atrial fibrillation/flutter during this admission that could be causal in the stroke etiologies in these three patients. Active infectious processes triggering atrial fibrillation events have been described (10) and increasing reports suggest a cardiac involvement with COVID-19 infections (11, 12). Of note, none of the cardiac arrhythmias were observed in patients who received hydroxychloroquine. All except one patient in our study had a diagnosis of either DM or hypertension (most having both), and the one patient who did not have a prior diagnosis of DM, was found to be pre-diabetic on testing. Although these could be argued as potential confounders from a stroke etiologic standpoint, the presence of these comorbid conditions has been associated with a higher risk of having a COVID-19 infection, and with greater disease severity (13). In this setting, it needs to be ascertained if the presence of hypertension, DM and related upregulation of the ACE2 could contribute to an increased risk of stroke in these patients. In our study, we observed that the average age of COVID-19 stroke pres...

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.