Stroke in Patients with COVID-19: Current Perspectives on Epidemiology, Pathophysiological Mechanisms, Clinical Features, and Outcomes (Systematic Review)

Zhanat K. Shaikhina, A. Kozhain-Akhmet, G. Perneshova, A. Kuandyk, E. Serikuly, Z. Turbasov, Marina R. Izmailovich

Juvenis scientia, 2026

Full text Open access: Gold Metadata (CSL-JSON)
DOI 10.32415/jscientia_2026_12_3_5-15
Data confidence 70 medium
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Abstract

Introduction. Coronavirus disease 2019 (COVID‑19), caused by SARS-CoV‑2, is associated with systemic complications, including cerebrovascular events. Stroke is one of the most severe neurological complications of COVID‑19 and is linked to increased mortality, disability, and poor functional outcomes. Aim. To summarize current evidence on the epidemiology, mechanisms, clinical features, and outcomes of stroke in patients with COVID‑19. Materials and Methods. A structured PubMed/MEDLINE search was conducted for original clinical studies published between December 2019 and March 2026. The search was limited to English-­language human studies; preprints were excluded. Study selection was conducted within a PRISMA-guided structured narrative review framework. The quality of observational studies was assessed using the Newcastle–Ottawa Scale, and findings were synthesized qualitatively. Results. Twelve original clinical studies comprising a total of 513,055 participants across the included study populations were included in the qualitative synthesis. COVID‑19‑associated stroke was most often ischemic and frequently accompanied by large-­vessel occlusion, elevated inflammatory and coagulation markers, cryptogenic mechanisms, and severe neurological deficits. Studies showed heterogeneity in patient populations, COVID‑19 severity, stroke subtype, biomarkers, and outcomes. Proposed mechanisms include endothelial dysfunction, hypercoagulability, systemic inflammation, cardiac complications, and hypoxemia. Conclusion. COVID‑19 should be considered an important precipitating factor for cerebrovascular complications, particularly ischemic stroke. Early neurological assessment and individualized risk stratification may improve outcomes.