Background and purpose: Coronavirus disease 2019 (COVID-19) is associated with a small but clinically significant risk of stroke, the cause of which is frequently cryptogenic In a large multinational cohort of consecutive COVID-19 patients with stroke, we evaluated clinical predictors of cryptogenic stroke, short-term functional outcomes and in-hospital mortality among patients according to stroke etiology Methods: We explored clinical characteristics and short-term outcomes of consecutively evaluated patients 18 years of age or older with acute ischemic stroke (AIS) and laboratory-confirmed COVID- 19 from 31 hospitals in 4 countries (3/1/20-6/16/20) Results: Of the 14 483 laboratory-confirmed patients with COVID-19, 156 (1 1%) were diagnosed with AIS Sixty-one (39 4%) were female, 84 (67 2%) white, and 88 (61 5%) were between 60-79 years of age The most frequently reported etiology of AIS was cryptogenic (55/129, 42 6%), which was associated with significantly higher white blood cell count, c-reactive protein, and D-dimer levels than non-cryptogenic AIS patients (p&lt;/=0 05 for all comparisons) In a multivariable backward stepwise regression model estimating the odds of in-hospital mortality, cryptogenic stroke mechanism was associated with a fivefold greater odds in-hospital mortality than strokes due to any other mechanism (adjusted OR 5 16, 95%CI 1 41-18 87, p=0 01) In that model, older age (aOR2 05 per decade, 95%CI 1 35-3 11, p&lt;0 01) and higher baseline NIHSS (aOR 1 12, 95%CI 1 02-1 21, p=0 01) were also independently predictive of mortality Conclusions: Our findings suggest that cryptogenic stroke among COVID-19 patients may berelated to more severe disease and carries a significant risk of early mortality
Stroke etiologies in patients with COVID-19: the svin COVID-19 multinational registry