220 - Acute Inpatient Rehabilitation Outcomes of Stroke Patients with COVID-19

Objectives: Evidence demonstrates an association between COVID-19 and stroke, and it highlights the difference in affected population, clinical presentation, and outcomes between COVID-19 positive and COVID-19 negative stroke patients. The incidence of COVID-19-related strokes has ranged from 1-6% among patients hospitalized with COVID-19. A predominance of ischemic stroke has been reported, but with a significant increase in cryptogenic etiology. Studies have described large vessel involvement, including younger patients without traditional risk factors or typical manifestations of COVID-19 at stroke onset, with a disproportionate impact on male and non-white individuals. Differences may relate to the multiple pathogenic mechanisms proposed for COVID-19-related stroke including coagulopathy, inflammation, endotheliopathy, platelet activation, and cardio embolism. Most concerning, outcomes among COVID-19 stroke patients seem much worse than in stroke patients without COVID-19 relative to discharge disposition. This study seeks to determine the differences between the two groups at admission and at discharge from inpatient rehabilitation facilities.

Design: Retrospective analysis of 40,296 patients diagnosed with a stroke, with and without COVID-19 in Acute Inpatient Rehabilitation setting from multiple Encompass Health locations.


Results: The median length of stay was longer for COVID negative patients than for COVID positive (14 vs 17, respectively). The total mobility and total self-care scores were higher in the COVID negative patients at discharge from inpatient rehabilitation. More COVID negative patients discharged to the community after inpatient rehabilitation (78% without COVID, 65% with COVID).

Conclusions: COVID-19 has an impact on functional and discharge outcomes for stroke patients during an inpatient rehabilitation stay.