Influencing factors of early neurological deterioration in COVID-19 -associated acute ischemic stroke

Abstract Coronavirus Disease-2019 (COVID-19) contributes to dysfunction and increased mortality in patients with acute ischemic stroke (AIS). However, whether COVID-19 causes early neurological deterioration (END) in patients with AIS and its underlying influencing factors are currently unclear.To a...

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Main Authors: Jian Wang, Lin Tao
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-13173-2
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author Jian Wang
Lin Tao
author_facet Jian Wang
Lin Tao
author_sort Jian Wang
collection DOAJ
description Abstract Coronavirus Disease-2019 (COVID-19) contributes to dysfunction and increased mortality in patients with acute ischemic stroke (AIS). However, whether COVID-19 causes early neurological deterioration (END) in patients with AIS and its underlying influencing factors are currently unclear.To ascertain the autonomous risk factors associated with END in stroke cases related to COVID-19. This is a retrospective observational study of data collected from November 2022 to February 2023 from patients with AIS complicated with COVID-19. The patients were divided into non-END and END groups, and their demographic characteristics, laboratory and imaging data were analyzed to investigate the risk factors for END in AIS patients complicated with COVID-19. A total of 83 patients were enrolled in this study, and divided in to END (n = 22) and non-END (n = 61) groups. We found that patients with high baseline the National Institutes of Health Stroke Scale (NIHSS) score (P = 0.044), preexisting diabetes (P < 0.01), stroke (P < 0.01) and abnormal electrocardiogram (P < 0.01) were prone to END. Compared to patients with non-END, the serum high-sensitivity C-reactive proteinhs(hs-CRP, P < 0.01), the high-sensitivity cardiac troponin (hs-CTN, P < 0.01), the prothrombin time (PT, P < 0.01), and the D-Dimer(DD, P < 0.01) were obviously increased in patients with EDN. Furthermore, multivariate Logistic regression analysis identified preexisting diabetes, stroke, high baseline NIHSS score, abnormal electrocardiogram, prolonged PT value, increased hs-CRP and elevated DD as independent risk factors for ENG in COVID-19-associated AIS. Patients with preexisting diabetes, stroke, high baseline NIHSS score, abnormal electrocardiogram, prolonged serum PT value, significantly increased hs-CRP and DD are prone to END in COVID-19-associated AIS.
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spelling doaj-art-be531d90405a40188d2b2d4c16b2d1dc2025-08-20T03:45:48ZengNature PortfolioScientific Reports2045-23222025-07-011511810.1038/s41598-025-13173-2Influencing factors of early neurological deterioration in COVID-19 -associated acute ischemic strokeJian Wang0Lin Tao1Department of Neurology, Affiliated Aerospace Hospital of Zunyi Medical UniversityDisease Prevention and Control Center of Huaxi DistrictAbstract Coronavirus Disease-2019 (COVID-19) contributes to dysfunction and increased mortality in patients with acute ischemic stroke (AIS). However, whether COVID-19 causes early neurological deterioration (END) in patients with AIS and its underlying influencing factors are currently unclear.To ascertain the autonomous risk factors associated with END in stroke cases related to COVID-19. This is a retrospective observational study of data collected from November 2022 to February 2023 from patients with AIS complicated with COVID-19. The patients were divided into non-END and END groups, and their demographic characteristics, laboratory and imaging data were analyzed to investigate the risk factors for END in AIS patients complicated with COVID-19. A total of 83 patients were enrolled in this study, and divided in to END (n = 22) and non-END (n = 61) groups. We found that patients with high baseline the National Institutes of Health Stroke Scale (NIHSS) score (P = 0.044), preexisting diabetes (P < 0.01), stroke (P < 0.01) and abnormal electrocardiogram (P < 0.01) were prone to END. Compared to patients with non-END, the serum high-sensitivity C-reactive proteinhs(hs-CRP, P < 0.01), the high-sensitivity cardiac troponin (hs-CTN, P < 0.01), the prothrombin time (PT, P < 0.01), and the D-Dimer(DD, P < 0.01) were obviously increased in patients with EDN. Furthermore, multivariate Logistic regression analysis identified preexisting diabetes, stroke, high baseline NIHSS score, abnormal electrocardiogram, prolonged PT value, increased hs-CRP and elevated DD as independent risk factors for ENG in COVID-19-associated AIS. Patients with preexisting diabetes, stroke, high baseline NIHSS score, abnormal electrocardiogram, prolonged serum PT value, significantly increased hs-CRP and DD are prone to END in COVID-19-associated AIS.https://doi.org/10.1038/s41598-025-13173-2COVID-19Acute ischemic strokeEarly neurological deteriorationRisk factors
spellingShingle Jian Wang
Lin Tao
Influencing factors of early neurological deterioration in COVID-19 -associated acute ischemic stroke
Scientific Reports
COVID-19
Acute ischemic stroke
Early neurological deterioration
Risk factors
title Influencing factors of early neurological deterioration in COVID-19 -associated acute ischemic stroke
title_full Influencing factors of early neurological deterioration in COVID-19 -associated acute ischemic stroke
title_fullStr Influencing factors of early neurological deterioration in COVID-19 -associated acute ischemic stroke
title_full_unstemmed Influencing factors of early neurological deterioration in COVID-19 -associated acute ischemic stroke
title_short Influencing factors of early neurological deterioration in COVID-19 -associated acute ischemic stroke
title_sort influencing factors of early neurological deterioration in covid 19 associated acute ischemic stroke
topic COVID-19
Acute ischemic stroke
Early neurological deterioration
Risk factors
url https://doi.org/10.1038/s41598-025-13173-2
work_keys_str_mv AT jianwang influencingfactorsofearlyneurologicaldeteriorationincovid19associatedacuteischemicstroke
AT lintao influencingfactorsofearlyneurologicaldeteriorationincovid19associatedacuteischemicstroke