Predictors of mortality for patients with COVID-19 and large vessel occlusion.
Adult
Aged
Aged, 80 and over
Arterial Occlusive Diseases
/ mortality
COVID-19
Cohort Studies
Coronavirus Infections
/ complications
Female
Ferritins
/ blood
Fibrin Fibrinogen Degradation Products
/ analysis
Hospital Mortality
Humans
Lung Diseases
/ etiology
Male
Middle Aged
Pandemics
Pneumonia, Viral
/ complications
Predictive Value of Tests
Retrospective Studies
Risk Assessment
Risk Factors
Smoking
/ mortality
Stroke
/ etiology
Treatment Outcome
COVID-19
Ischemic stroke
emergent large vessel occlusion
mechanical thrombectomy
outcomes
Journal
Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences
ISSN: 2385-2011
Titre abrégé: Interv Neuroradiol
Pays: United States
ID NLM: 9602695
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
pubmed:
31
8
2020
medline:
30
10
2020
entrez:
1
9
2020
Statut:
ppublish
Résumé
This study evaluates the mortality risk of patients with emergent large vessel occlusion (ELVO) and COVID-19 during the pandemic. We performed a retrospective cohort study of two cohorts of consecutive patients with ELVO admitted to a quaternary hospital from March 1 to April 17, 2020. We abstracted data from electronic health records on baseline, biomarker profiles, key time points, quality measures and radiographic data. Of 179 patients admitted with ischemic stroke, 36 had ELVO. Patients with COVID-19 and ELVO had a higher risk of mortality during the pandemic versus patients without COVID-19 (OR 16.63, p = 0.004). An age-based sub-analysis showed in-hospital mortality in 60% of COVID-19 positive patients between 61-70 years-old, 66.7% in between 51-60 years-old, 50% in between 41-50 years-old and 33.3% in between 31-40 years old. Patients that presented with pulmonary symptoms at time of stroke presentation had 71.4% mortality rate. 27.3% of COVID-19 patients presenting with ELVO had a good outcome at discharge (mRS 0-2). Patients with a history of cigarette smoking (p = 0.003), elevated d-dimer (p = 0.007), failure to recanalize (p = 0.007), and elevated ferritin levels (p = 0.006) had an increased risk of mortality. Patients with COVID-19 and ELVO had a significantly higher risk for mortality compared to COVID-19 negative patients with ELVO. A small percentage of COVID-19 ELVO patients had good outcomes. Age greater than 60 and pulmonary symptoms at presentation have higher risk for mortality. Other risk factors for mortality were a history of cigarette smoking, elevated, failure to recanalize, elevated d-dimer and ferritin levels.
Sections du résumé
BACKGROUND
BACKGROUND
This study evaluates the mortality risk of patients with emergent large vessel occlusion (ELVO) and COVID-19 during the pandemic.
METHODS
METHODS
We performed a retrospective cohort study of two cohorts of consecutive patients with ELVO admitted to a quaternary hospital from March 1 to April 17, 2020. We abstracted data from electronic health records on baseline, biomarker profiles, key time points, quality measures and radiographic data.
RESULTS
RESULTS
Of 179 patients admitted with ischemic stroke, 36 had ELVO. Patients with COVID-19 and ELVO had a higher risk of mortality during the pandemic versus patients without COVID-19 (OR 16.63, p = 0.004). An age-based sub-analysis showed in-hospital mortality in 60% of COVID-19 positive patients between 61-70 years-old, 66.7% in between 51-60 years-old, 50% in between 41-50 years-old and 33.3% in between 31-40 years old. Patients that presented with pulmonary symptoms at time of stroke presentation had 71.4% mortality rate. 27.3% of COVID-19 patients presenting with ELVO had a good outcome at discharge (mRS 0-2). Patients with a history of cigarette smoking (p = 0.003), elevated d-dimer (p = 0.007), failure to recanalize (p = 0.007), and elevated ferritin levels (p = 0.006) had an increased risk of mortality.
CONCLUSION
CONCLUSIONS
Patients with COVID-19 and ELVO had a significantly higher risk for mortality compared to COVID-19 negative patients with ELVO. A small percentage of COVID-19 ELVO patients had good outcomes. Age greater than 60 and pulmonary symptoms at presentation have higher risk for mortality. Other risk factors for mortality were a history of cigarette smoking, elevated, failure to recanalize, elevated d-dimer and ferritin levels.
Identifiants
pubmed: 32862753
doi: 10.1177/1591019920954603
pmc: PMC7586005
doi:
Substances chimiques
Fibrin Fibrinogen Degradation Products
0
fibrin fragment D
0
Ferritins
9007-73-2
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
623-628Références
J Neurol Neurosurg Psychiatry. 2020 Aug;91(8):889-891
pubmed: 32354768
Stroke. 2020 Aug;51(8):2540-2543
pubmed: 32466736
Neurocrit Care. 2020 Jun;32(3):667-671
pubmed: 32346843
J Thromb Thrombolysis. 2020 Oct;50(3):587-595
pubmed: 32661757
N Engl J Med. 2020 May 14;382(20):e60
pubmed: 32343504
JAMA Neurol. 2020 Jun 1;77(6):683-690
pubmed: 32275288
Stroke. 2019 Dec;50(12):e344-e418
pubmed: 31662037