tetano
Editor, Senior Moderator
Stroke
. 2021 Aug 30;STROKEAHA121034883.
doi: 10.1161/STROKEAHA.121.034883. Online ahead of print.
Impact of COVID-19 Infection on the Outcome of Patients With Ischemic Stroke
Joan Martí-Fàbregas[SUP] 1 [/SUP], Daniel Guisado-Alonso[SUP] 1 [/SUP], Raquel Delgado-Mederos[SUP] 1 [/SUP], Alejandro Martínez-Domeño[SUP] 1 [/SUP], Luis Prats-Sánchez[SUP] 1 [/SUP], Marina Guasch-Jiménez[SUP] 1 [/SUP], Pere Cardona[SUP] 2 [/SUP], Ana Núñez-Guillén[SUP] 2 [/SUP], Manuel Requena[SUP] 3 [/SUP], Marta Rubiera[SUP] 3 [/SUP], Marta Olivé[SUP] 3 [/SUP], Alejandro Bustamante[SUP] 4 [/SUP], Meritxell Gomis[SUP] 4 [/SUP], Sergio Amaro[SUP] 5 [/SUP], Laura Llull[SUP] 5 [/SUP], Xavier Ustrell[SUP] 6 [/SUP], Gislaine Castilho de Oliveira[SUP] 6 [/SUP], Laia Seró[SUP] 6 [/SUP], Manuel Gomez-Choco[SUP] 7 [/SUP], Luis Mena[SUP] 7 [/SUP], Joaquín Serena[SUP] 8 [/SUP], Saima Bashir Viturro[SUP] 8 [/SUP], Francisco Purroy[SUP] 9 [/SUP], Mikel Vicente[SUP] 9 [/SUP], Ana Rodríguez-Campello[SUP] 10 [/SUP], Angel Ois[SUP] 10 [/SUP], Esther Catena[SUP] 11 [/SUP], Maria Carmen Garcia-Carreira[SUP] 12 [/SUP], Oriol Barrachina[SUP] 12 [/SUP], Ernest Palomeras[SUP] 13 [/SUP], Jerzky Krupinski[SUP] 14 [/SUP], Marta Almeria[SUP] 14 [/SUP], Josep Zaragoza[SUP] 15 [/SUP], Patricia Esteve[SUP] 15 [/SUP], Dolores Cocho[SUP] 16 [/SUP], Antia Moreira[SUP] 10 17 [/SUP], Cecile van Eendenburg[SUP] 18 [/SUP], Javier Emilio Codas[SUP] 19 [/SUP], Natalia Pérez de la Ossa[SUP] 20 [/SUP], Mercè Salvat[SUP] 20 [/SUP], Pol Camps-Renom[SUP] 1 [/SUP]
Affiliations
Abstract
Background and purpose: We evaluated whether stroke severity, functional outcome, and mortality are different in patients with ischemic stroke with or without coronavirus disease 2019 (COVID-19) infection.
Methods: A prospective, observational, multicentre cohort study in Catalonia, Spain. Recruitment was consecutive from mid-March to mid-May 2020. Patients had an acute ischemic stroke within 48 hours and a previous modified Rankin Scale (mRS) score of 0 to 3. We collected demographic data, vascular risk factors, prior mRS score, National Institutes of Health Stroke Scale score, rate of reperfusion therapies, logistics, and metrics. Primary end point was functional outcome at 3 months. Favourable outcome was defined depending on the previous mRS score. Secondary outcome was mortality at 3 months. We performed mRS shift and multivariable analyses.
Results: We evaluated 701 patients (mean age 72.3±13.3 years, 60.5% men) and 91 (13%) had COVID-19 infection. Median baseline National Institutes of Health Stroke Scale score was higher in patients with COVID-19 compared with patients without COVID-19 (8 [3-18] versus 6 [2-14], P=0.049). Proportion of patients with a favourable functional outcome was 33.7% in the COVID-19 and 47% in the non-COVID-19 group. However, after a multivariable logistic regression analysis, COVID-19 infection did not increase the probability of unfavourable functional outcome. Mortality rate was 39.3% among patients with COVID-19 and 16.1% in the non-COVID-19 group. In the multivariable logistic regression analysis, COVID-19 infection was a risk factor for mortality (hazard ratio, 3.14 [95% CI, 2.10-4.71]; P<0.001).
Conclusions: Patients with ischemic stroke and COVID-19 infection have more severe strokes and a higher mortality than patients with stroke without COVID-19 infection. However, functional outcome is comparable in both groups.
Keywords: cerebrovascular disease; coronavirus; pandemics; prognosis; reperfusion; stroke; thrombectomy.
. 2021 Aug 30;STROKEAHA121034883.
doi: 10.1161/STROKEAHA.121.034883. Online ahead of print.
Impact of COVID-19 Infection on the Outcome of Patients With Ischemic Stroke
Joan Martí-Fàbregas[SUP] 1 [/SUP], Daniel Guisado-Alonso[SUP] 1 [/SUP], Raquel Delgado-Mederos[SUP] 1 [/SUP], Alejandro Martínez-Domeño[SUP] 1 [/SUP], Luis Prats-Sánchez[SUP] 1 [/SUP], Marina Guasch-Jiménez[SUP] 1 [/SUP], Pere Cardona[SUP] 2 [/SUP], Ana Núñez-Guillén[SUP] 2 [/SUP], Manuel Requena[SUP] 3 [/SUP], Marta Rubiera[SUP] 3 [/SUP], Marta Olivé[SUP] 3 [/SUP], Alejandro Bustamante[SUP] 4 [/SUP], Meritxell Gomis[SUP] 4 [/SUP], Sergio Amaro[SUP] 5 [/SUP], Laura Llull[SUP] 5 [/SUP], Xavier Ustrell[SUP] 6 [/SUP], Gislaine Castilho de Oliveira[SUP] 6 [/SUP], Laia Seró[SUP] 6 [/SUP], Manuel Gomez-Choco[SUP] 7 [/SUP], Luis Mena[SUP] 7 [/SUP], Joaquín Serena[SUP] 8 [/SUP], Saima Bashir Viturro[SUP] 8 [/SUP], Francisco Purroy[SUP] 9 [/SUP], Mikel Vicente[SUP] 9 [/SUP], Ana Rodríguez-Campello[SUP] 10 [/SUP], Angel Ois[SUP] 10 [/SUP], Esther Catena[SUP] 11 [/SUP], Maria Carmen Garcia-Carreira[SUP] 12 [/SUP], Oriol Barrachina[SUP] 12 [/SUP], Ernest Palomeras[SUP] 13 [/SUP], Jerzky Krupinski[SUP] 14 [/SUP], Marta Almeria[SUP] 14 [/SUP], Josep Zaragoza[SUP] 15 [/SUP], Patricia Esteve[SUP] 15 [/SUP], Dolores Cocho[SUP] 16 [/SUP], Antia Moreira[SUP] 10 17 [/SUP], Cecile van Eendenburg[SUP] 18 [/SUP], Javier Emilio Codas[SUP] 19 [/SUP], Natalia Pérez de la Ossa[SUP] 20 [/SUP], Mercè Salvat[SUP] 20 [/SUP], Pol Camps-Renom[SUP] 1 [/SUP]
Affiliations
- PMID: 34455823
- DOI: 10.1161/STROKEAHA.121.034883
Abstract
Background and purpose: We evaluated whether stroke severity, functional outcome, and mortality are different in patients with ischemic stroke with or without coronavirus disease 2019 (COVID-19) infection.
Methods: A prospective, observational, multicentre cohort study in Catalonia, Spain. Recruitment was consecutive from mid-March to mid-May 2020. Patients had an acute ischemic stroke within 48 hours and a previous modified Rankin Scale (mRS) score of 0 to 3. We collected demographic data, vascular risk factors, prior mRS score, National Institutes of Health Stroke Scale score, rate of reperfusion therapies, logistics, and metrics. Primary end point was functional outcome at 3 months. Favourable outcome was defined depending on the previous mRS score. Secondary outcome was mortality at 3 months. We performed mRS shift and multivariable analyses.
Results: We evaluated 701 patients (mean age 72.3±13.3 years, 60.5% men) and 91 (13%) had COVID-19 infection. Median baseline National Institutes of Health Stroke Scale score was higher in patients with COVID-19 compared with patients without COVID-19 (8 [3-18] versus 6 [2-14], P=0.049). Proportion of patients with a favourable functional outcome was 33.7% in the COVID-19 and 47% in the non-COVID-19 group. However, after a multivariable logistic regression analysis, COVID-19 infection did not increase the probability of unfavourable functional outcome. Mortality rate was 39.3% among patients with COVID-19 and 16.1% in the non-COVID-19 group. In the multivariable logistic regression analysis, COVID-19 infection was a risk factor for mortality (hazard ratio, 3.14 [95% CI, 2.10-4.71]; P<0.001).
Conclusions: Patients with ischemic stroke and COVID-19 infection have more severe strokes and a higher mortality than patients with stroke without COVID-19 infection. However, functional outcome is comparable in both groups.
Keywords: cerebrovascular disease; coronavirus; pandemics; prognosis; reperfusion; stroke; thrombectomy.