Leveron&Nexovas
Neurology India
menu-bar5 Open access journal indexed with Index Medicus
  Users online: 2713  
 Home | Login 
About Editorial board Articlesmenu-bullet NSI Publicationsmenu-bullet Search Instructions Online Submission Subscribe Videos Etcetera Contact
  Navigate Here 
 Search
 
  
 Resource Links
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Article in PDF (564 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this Article
   References
   Article Tables

 Article Access Statistics
    Viewed192    
    Printed6    
    Emailed0    
    PDF Downloaded1    
    Comments [Add]    

Recommend this journal

 


 
Table of Contents    
LETTER TO EDITOR
Year : 2022  |  Volume : 70  |  Issue : 2  |  Page : 812-813

Use of poststroke medications and COVID-19-associated mortality


1 Department of Neurology, Korea University Ansan Hospital, Ansan, South Korea
2 Department of Data Science Analysis, Hanmi Pharmacy, Seoul, South Korea

Date of Submission25-Aug-2020
Date of Decision12-Feb-2021
Date of Acceptance12-Apr-2021
Date of Web Publication3-May-2022

Correspondence Address:
Dr. Moon Ho Park
Department of Neurology, Korea University Ansan Hospital, 123 Jeokgeum-ro, Danwon-gu, Ansan-shi, Gyeonggi-do 15355
South Korea
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.344614

Rights and Permissions



How to cite this article:
Park MH, Kyoung DS. Use of poststroke medications and COVID-19-associated mortality. Neurol India 2022;70:812-3

How to cite this URL:
Park MH, Kyoung DS. Use of poststroke medications and COVID-19-associated mortality. Neurol India [serial online] 2022 [cited 2022 Jun 27];70:812-3. Available from: https://www.neurologyindia.com/text.asp?2022/70/2/812/344614




Sir,

Coronavirus disease 2019 (COVID-19) has emerged as a global pandemic and has become a worldwide health threat. Although the major clinical manifestations of COVID-19 are respiratory manifestations, there are experimental findings that suggest an association between SARS-CoV-2 infection and stroke.[1] There are practical recommendations for management of acute ischemic stroke during the COVID-19 pandemics.[2] Like the management of acute ischemic stroke, that of poststroke is also important because numerous poststroke patients reside in convalescent hospitals and nursing homes, where are vulnerable to infection clusters associated with COVID-19, and stroke itself has been identified as both a critical comorbidity for COVID-19 and a high-risk factor for poor prognosis.

However, controversy exists regarding the links between COVID-19 and therapeutics for poststroke and stroke-associated risk factors. For instance, clopidogrel, a P2Y12 receptor adenosine diphosphate (ADP) antagonist, can prevent infection-induced platelet hyperactivity, via ADP signaling, and whether angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers, which are used for the treatment of hypertension, and thiazolidinedione, which is used to treat diabetes, can facilitate COVID-19 remains under debate.[2] Additionally, statins have been associated with a lower risk of mortality in COVID-19.[3]

We evaluated the national COVID-19 claim database of South Korea and identified 5,726 patients with PCR-confirmed COVID-19, of whom 140 had died.[4] Our observations revealed no significant relationship between COVID-19-associated mortality and ongoing, poststroke, medication management, after adjusting for clinically relevant potential confounders, including age, sex, and comorbidities. A similar result was consistently observed, both during the overall analysis of all COVID-19 patients and in the subgroup analysis, which was limited to patients with stroke [Table 1].
Table 1: Likelihood of mortality in patients with confirmed COVID-19 according to treatment with various medications of interest

Click here to view


These results may not be surprising to some. However, given the possibility of an association between stroke and COVID-19-associated mortality, the ongoing treatment of patients should be based on evidence. The results of this study are critical as they suggest that ongoing treatment with the aforementioned critical antiplatelet, anticoagulant, antihypertensive, and antidiabetic agents may proceed without increasing the risk of poor prognosis in the face of COVID-19.

There are several limitations to this retrospective study. The results should be interpreted carefully given the disadvantages associated with a study of this nature.

In conclusion, our study revealed no association between the poststroke medications with an increased risk of mortality among patients diagnosed with COVID-19. During the unprecedented COVID-19 pandemic, the ongoing-treatment of poststroke patients should be provided adequately and continuously.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Garg RK. Spectrum of neurological manifestations in Covid-19: A review. Neurol India 2020;68:560-72.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Qureshi AI, Abd-Allah F, Al-Senani F, Aytac E, Borhani-Haghighi A, Ciccone A, et al. Management of acute ischemic stroke in patients with COVID-19 infection: Report of an international panel. Int J Stroke 2020;15:540-54.  Back to cited text no. 2
    
3.
Zhang XJ, Qin JJ, Cheng X, Shen L, Zhao YC, Yuan Y, et al. In-hospital use of statins is associated with a reduced risk of mortality among individuals with COVID-19. Cell Metab 2020;32:176-87.  Back to cited text no. 3
    
4.
Korea Ministry of Health and Welfare, Health Insurance Review & Assessment Service. #opendata4covid19. Available from: https://hira-covid19.net/. [Last accessed on 2020 Apr 15].  Back to cited text no. 4
    



 
 
    Tables

  [Table 1]



 

Top
Print this article  Email this article
   
Online since 20th March '04
Published by Wolters Kluwer - Medknow