SARS-CoV-2 and Stroke in a New York Healthcare System.
Adult
Aged
Betacoronavirus
Biomarkers
Blood Sedimentation
Brain Ischemia
/ blood
COVID-19
Causality
Cerebral Small Vessel Diseases
/ complications
Comorbidity
Coronavirus Infections
/ blood
Female
Fibrin Fibrinogen Degradation Products
/ analysis
Humans
Incidence
Male
Middle Aged
Neuroimaging
New York City
/ epidemiology
Pandemics
Patient Admission
/ statistics & numerical data
Pneumonia, Viral
/ blood
Retrospective Studies
SARS-CoV-2
Severity of Illness Index
Stroke
/ blood
Thrombophilia
/ etiology
Troponin
/ blood
COVID-19
coronavirus
diagnosis
pandemic
troponin
Journal
Stroke
ISSN: 1524-4628
Titre abrégé: Stroke
Pays: United States
ID NLM: 0235266
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
pubmed:
21
5
2020
medline:
7
7
2020
entrez:
21
5
2020
Statut:
ppublish
Résumé
With the spread of coronavirus disease 2019 (COVID-19) during the current worldwide pandemic, there is mounting evidence that patients affected by the illness may develop clinically significant coagulopathy with thromboembolic complications including ischemic stroke. However, there is limited data on the clinical characteristics, stroke mechanism, and outcomes of patients who have a stroke and COVID-19. We conducted a retrospective cohort study of consecutive patients with ischemic stroke who were hospitalized between March 15, 2020, and April 19, 2020, within a major health system in New York, the current global epicenter of the pandemic. We compared the clinical characteristics of stroke patients with a concurrent diagnosis of COVID-19 to stroke patients without COVID-19 (contemporary controls). In addition, we compared patients to a historical cohort of patients with ischemic stroke discharged from our hospital system between March 15, 2019, and April 15, 2019 (historical controls). During the study period in 2020, out of 3556 hospitalized patients with diagnosis of COVID-19 infection, 32 patients (0.9%) had imaging proven ischemic stroke. Cryptogenic stroke was more common in patients with COVID-19 (65.6%) as compared to contemporary controls (30.4%, We observed a low rate of imaging-confirmed ischemic stroke in hospitalized patients with COVID-19. Most strokes were cryptogenic, possibly related to an acquired hypercoagulability, and mortality was increased. Studies are needed to determine the utility of therapeutic anticoagulation for stroke and other thrombotic event prevention in patients with COVID-19.
Sections du résumé
BACKGROUND AND PURPOSE
With the spread of coronavirus disease 2019 (COVID-19) during the current worldwide pandemic, there is mounting evidence that patients affected by the illness may develop clinically significant coagulopathy with thromboembolic complications including ischemic stroke. However, there is limited data on the clinical characteristics, stroke mechanism, and outcomes of patients who have a stroke and COVID-19.
METHODS
We conducted a retrospective cohort study of consecutive patients with ischemic stroke who were hospitalized between March 15, 2020, and April 19, 2020, within a major health system in New York, the current global epicenter of the pandemic. We compared the clinical characteristics of stroke patients with a concurrent diagnosis of COVID-19 to stroke patients without COVID-19 (contemporary controls). In addition, we compared patients to a historical cohort of patients with ischemic stroke discharged from our hospital system between March 15, 2019, and April 15, 2019 (historical controls).
RESULTS
During the study period in 2020, out of 3556 hospitalized patients with diagnosis of COVID-19 infection, 32 patients (0.9%) had imaging proven ischemic stroke. Cryptogenic stroke was more common in patients with COVID-19 (65.6%) as compared to contemporary controls (30.4%,
CONCLUSIONS
We observed a low rate of imaging-confirmed ischemic stroke in hospitalized patients with COVID-19. Most strokes were cryptogenic, possibly related to an acquired hypercoagulability, and mortality was increased. Studies are needed to determine the utility of therapeutic anticoagulation for stroke and other thrombotic event prevention in patients with COVID-19.
Identifiants
pubmed: 32432996
doi: 10.1161/STROKEAHA.120.030335
pmc: PMC7258764
doi:
Substances chimiques
Biomarkers
0
Fibrin Fibrinogen Degradation Products
0
Troponin
0
fibrin fragment D
0
Types de publication
Comparative Study
Journal Article
Multicenter Study
Observational Study
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
2002-2011Subventions
Organisme : NINDS NIH HHS
ID : K08 NS091499
Pays : United States
Commentaires et corrections
Type : CommentIn
Type : ErratumIn
Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : CommentIn
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