Abstract TMP18: Global Estimates Of Frequency And Outcomes Of Coronavirus Disease 2019 Associated Stroke And Myocardial Infarction

Background: We evaluated the frequency and outcomes of Coronavirus Disease 2019 (COVID-19) associated stroke (ischemic and hemorrhagic) and myocardial infarction (MI) in a global research network. Methods: All adult (≥ 18 years) patients with ICD-10 diagnoses of COVID-19 were included and those with a stroke (ischemic stroke, intracerebral hemorrhage [ICH], transient ischemic attach [TIA] or subarachnoid hemorrhage [SAH]) or myocardial infarction (MI) ± 28 days from COVID-19 diagnosis were flagged. Individuals with a prior history of stroke / MI were excluded. COVID-19 associated stroke (CAS) and MI (CAM) frequencies were compared to prior AHA-reported population-based incidences. Severe COVID-19 disease (use of ventilator, intubation, or life support) and 90-day mortality were evaluated among no-stroke/MI and stroke/MI subgroups utilizing general linear models adjusted for age, sex, race/ethnicity, and Charlson Comorbidity Index scores. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) are reported. Results: Between Jan 2020 and Jul 2021, we identified 637,820 COVID-19 patients of whom 4,559 (0.71%) had a CAS and 6,972 (1.09%) had a CAM. COVID-19 was associated with significantly higher stroke/MI rates compared to population based reported incidence (ORs, CI for CAS 1.99, 1.93 - 2.05 and CAM 3.09, 3.01 - 3.16). Severe COVID disease was observed among 1.07% of COVID-19 only patients, 11.25% of CAS patients (aOR, CI: 4.82, 4.35 - 5.34), and 14.81% of CAM patients (aOR, CI: 5.77, 5.34 - 5.22). 90-Day mortality was 1.92% for COVID-19 only patients, 14.35% for CAS patients (aOR, CI: 3.16, 2.87 - 3.46), and 20.52% for CAM patients (aOR, CI: 4.12, 3.85 - 4.41). Group specific demographic and outcome proportions are reported (Figure). Conclusion: The COVID-19 pandemic has tremendously exacerbated the burden of cerebrovascular and cardiovascular disease globally. Continued work is needed to understand drivers of poor outcomes among COVID-19 patients.