Characteristics and Outcomes in Patients With COVID-19 and Acute Ischemic Stroke: The Global COVID-19 Stroke Registry.

Details

Serval ID
serval:BIB_7748F8CEFF78
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Characteristics and Outcomes in Patients With COVID-19 and Acute Ischemic Stroke: The Global COVID-19 Stroke Registry.
Journal
Stroke
Author(s)
Ntaios G., Michel P., Georgiopoulos G., Guo Y., Li W., Xiong J., Calleja P., Ostos F., González-Ortega G., Fuentes B., Alonso de Leciñana M., Díez-Tejedor E., García-Madrona S., Masjuan J., DeFelipe A., Turc G., Gonçalves B., Domigo V., Dan G.A., Vezeteu R., Christensen H., Christensen L.M., Meden P., Hajdarevic L., Rodriguez-Lopez A., Díaz-Otero F., García-Pastor A., Gil-Nuñez A., Maslias E., Strambo D., Werring D.J., Chandratheva A., Benjamin L., Simister R., Perry R., Beyrouti R., Jabbour P., Sweid A., Tjoumakaris S., Cuadrado-Godia E., Campello A.R., Roquer J., Moreira T., Mazya M.V., Bandini F., Matz K., Iversen H.K., González-Duarte A., Tiu C., Ferrari J., Vosko M.R., Salzer HJF, Lamprecht B., Dünser M.W., Cereda C.W., Quintero ÁBC, Korompoki E., Soriano-Navarro E., Soto-Ramírez L.E., Castañeda-Méndez P.F., Bay-Sansores D., Arauz A., Cano-Nigenda V., Kristoffersen E.S., Tiainen M., Strbian D., Putaala J., Lip GYH
ISSN
1524-4628 (Electronic)
ISSN-L
0039-2499
Publication state
Published
Issued date
09/2020
Peer-reviewed
Oui
Volume
51
Number
9
Pages
e254-e258
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Recent case-series of small size implied a pathophysiological association between coronavirus disease 2019 (COVID-19) and severe large-vessel acute ischemic stroke. Given that severe strokes are typically associated with poor prognosis and can be very efficiently treated with recanalization techniques, confirmation of this putative association is urgently warranted in a large representative patient cohort to alert stroke clinicians, and inform pre- and in-hospital acute stroke patient pathways. We pooled all consecutive patients hospitalized with laboratory-confirmed COVID-19 and acute ischemic stroke in 28 sites from 16 countries. To assess whether stroke severity and outcomes (assessed at discharge or at the latest assessment for those patients still hospitalized) in patients with acute ischemic stroke are different between patients with COVID-19 and non-COVID-19, we performed 1:1 propensity score matching analyses of our COVID-19 patients with non-COVID-19 patients registered in the Acute Stroke Registry and Analysis of Lausanne Registry between 2003 and 2019. Between January 27, 2020, and May 19, 2020, 174 patients (median age 71.2 years; 37.9% females) with COVID-19 and acute ischemic stroke were hospitalized (median of 12 patients per site). The median National Institutes of Health Stroke Scale was 10 (interquartile range [IQR], 4-18). In the 1:1 matched sample of 336 patients with COVID-19 and non-COVID-19, the median National Institutes of Health Stroke Scale was higher in patients with COVID-19 (10 [IQR, 4-18] versus 6 [IQR, 3-14]), P=0.03; (odds ratio, 1.69 [95% CI, 1.08-2.65] for higher National Institutes of Health Stroke Scale score). There were 48 (27.6%) deaths, of which 22 were attributed to COVID-19 and 26 to stroke. Among 96 survivors with available information about disability status, 49 (51%) had severe disability at discharge. In the propensity score-matched population (n=330), patients with COVID-19 had higher risk for severe disability (median mRS 4 [IQR, 2-6] versus 2 [IQR, 1-4], P<0.001) and death (odds ratio, 4.3 [95% CI, 2.22-8.30]) compared with patients without COVID-19. Our findings suggest that COVID-19 associated ischemic strokes are more severe with worse functional outcome and higher mortality than non-COVID-19 ischemic strokes.
Keywords
Aged, Aged, 80 and over, Brain Ischemia/complications, Brain Ischemia/diagnostic imaging, Brain Ischemia/therapy, Cohort Studies, Coronavirus Infections/complications, Coronavirus Infections/diagnostic imaging, Coronavirus Infections/therapy, Disability Evaluation, Female, Humans, Male, Middle Aged, Pandemics, Pneumonia, Viral/complications, Pneumonia, Viral/diagnostic imaging, Pneumonia, Viral/therapy, Propensity Score, Recovery of Function, Registries, Stroke/complications, Stroke/diagnostic imaging, Stroke/therapy, Survival Analysis, Time-to-Treatment, Tomography, X-Ray Computed, Treatment Outcome, COVID-19, coronavirus, prognosis, propensity score, survivors
Pubmed
Web of science
Open Access
Yes
Create date
28/08/2020 8:31
Last modification date
09/12/2020 6:26
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