our study, the ferritin level was found to be significantly higher in the COVID-19–positive AIS group compared with the negative group, and it was found to be associated with mortality in the COVID-19–positive group. According to the ROC curve analysis, the best cut-off point for ferritin was 111 ng/mL, the sensitivity was 83.72% and the specificity was 77.78%.
In a multivariate analysis of a retrospective series of 440 patients with severe COVID-19, age, prolongation of prothrombin time, increased D-dimer, and thrombocytopenia were found to be associated with mortality (30). In our study, mortality was found to be associated with increased D-dimer levels, ferritin levels and thrombocytopenia in the AIS group with COVID-19 (p=0.027, p=0.034, p=0.015). With these findings, it can be thought that regular platelet counts and D-dimer level observations can be planned to monitor the level of coagulopathy and disease severity.
The single-center nature of this study caused some limitations such as the limited number of patients, the retrospective analysis, not being able to perform advanced etiologic investigations in some patients with AIS and COVID-19, not including hemorrhagic strokes, and not being able to perform advanced laboratory investigations such as measuring antiphospholipid antibody levels and interleukin levels. The authors think that more data are needed in this area to determine the contribution of the processes involved in the pathogenesis of COVID-19 and stroke, and multicenter clinical studies with a higher number of patients are needed.