The impact of COVID-19 on stroke rehabilitation

Abstract

In literature, it has been suggested that SARS-CoV-2's impact on the heart and brain may contribute to immune-mediated thrombosis, the renin-angiotensin system related to the pathogenesis of ischemic stroke. Our study compares the rehabilitation outcomes of stroke patients with and without a history of COVID-19. Our study aims to compare rehabilitation results of COVID-19-associated ischemic stroke patients and non-COVID-19 patients, as thrombotic complications and ischemic stroke have largely been reported since the pandemic's beginning. This study included 83 stroke patients aged 18-80 years who were hospitalized and rehabilitated. Patients' age, gender, lesion location, Brunnstrom stage, ambulation level, comorbidities, Charlson comorbidity index, stroke type, pre-stroke history of COVID-19 and symptoms, previous stroke history, and duration of physical therapy program were recorded. Those with a history of COVID-19 reverse transcriptase polymerase chain reaction test being positive and/or a history of pneumonia compatible with COVID-19 on thoracic computed tomography examination (28 patients) were included in the COVID-19 group while those without those conditions were included in the non-COVID-19 group (55 patients). Factors contributing to rehabilitation results were compared between the groups. The rehabilitation outcomes were similar across the groups, with no differences in ambulation levels or Brunnstrom staging (hand, upper and lower extremities) (p values 0.237, 0.155, 0.380, 0.192, respectively). However, the COVID-19 group had higher rates of ischemic heart disease and hypothyroidism, no prior history of cerebrovascular accident, more periventricular infarctions, and initially more adversely affected ambulation levels (p values 0.047, 0.038, 0.042, 0.037, 0.028, respectively). The study concluded that there was no apparent difference between the two groups' outcome parameters. Although the COVID-19 group's ambulation level was initially more negatively impacted, no detrimental effects on rehabilitation outcomes were found.

Keywords

• cerebrovascular accident
• COVID-19
• ischemic heart disease
• rehabilitation
• stroke

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