Acute Ischemic Stroke (AIS) is currently the most frequently reported neurological complication
of Coronavirus disease 2019 (COVID-19). This article will elaborate the clinical features
of inpatients with COVID-19 and AIS and the pathophysiological mechanism of AIS under the
background of COVID-19. Through a detailed search of relevant studies, we found that the incidence
of AIS among COVID-19 patients varied from 0.9% to 4.6%, and AIS has been observed in
many people without an underlying disease and cardiovascular risk factors as well as young people.
The National Institute of Health Stroke Scale (NIHSS) score of COVID-19 patients with AIS
was higher than historical AIS patients, and the proportion of large vessel occlusion (LVO) was
about 64.2%. COVID-19 patients with AIS generally have high levels of D-D dimer, fibrinogen,
C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), suggesting systemic hyperinflammatory
and hypercoagulable state. The pooled mortality of COVID-19 patients with AIS was
38% and the mortality of LVO patients is higher (45.9%). Compared with COVID-19-negative
AIS patients in the same period in 2020 and 2019, COVID-19 patients with AIS had a worse prognosis.