Esenwa C, Cheng NT, Luna J, et al. - This study’s findings demonstrate that COVID-19–associated ischemic stroke may be related to COVID-19 illness severity and associated coagulopathy as characterized by increasing D-dimer burden.

• Researchers conducted a machine learning cluster analysis of common biomarkers in patients admitted with severe acute respiratory syndrome coronavirus 2 to ascertain whether any were correlated with acute ischemic stroke (AIS).

• Furthermore, based on levels of c-reactive protein, D-dimer, lactate dehydrogenase, white blood cell count, and partial thromboplastin time,

• Clustering grouped 2,908 unique patient encounters into 4 unique biomarker phenotypes.

• The results showed that the most severe cluster phenotypes had the highest prevalence of AIS (3.6%, P<0.001), in-hospital AIS (53%, P<0.002), severe AIS (31%, P=0.004), and cryptogenic AIS (73%, P<0.001).

• It was shown that D-dimer was the only biomarker independently correlated with prevalent AIS with quartile 4 having an 8-fold higher risk of AIS in comparison with quartile 1 (P=0.005), a finding that was further corroborated in a separate cohort of 157 patients hospitalized with COVID-19 and AIS.