COVID-19 and Stroke: Incidence and Etiological Description in a High-Volume Center.
Adult
Aged
Aged, 80 and over
Betacoronavirus
/ pathogenicity
COVID-19
Coronavirus Infections
/ epidemiology
Databases, Factual
Female
Hospital Mortality
Hospitals, High-Volume
Host-Pathogen Interactions
Humans
Incidence
Male
Middle Aged
Pandemics
Pneumonia, Viral
/ epidemiology
Prognosis
Prospective Studies
Risk Assessment
Risk Factors
SARS-CoV-2
Spain
Stroke
/ epidemiology
Time Factors
Acute stroke
COVID-19
Critical care
Pandemic
Journal
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN: 1532-8511
Titre abrégé: J Stroke Cerebrovasc Dis
Pays: United States
ID NLM: 9111633
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
26
06
2020
revised:
28
07
2020
accepted:
29
07
2020
entrez:
17
10
2020
pubmed:
18
10
2020
medline:
29
10
2020
Statut:
ppublish
Résumé
An increased rate of thrombotic events has been associated to Coronavirus Disease 19 (COVID-19) with a variable rate of acute stroke. Our aim is to uncover the rate of acute stroke in COVID-19 patients and identify those cases in which a possible causative relationship could exist. We performed a single-center analysis of a prospective mandatory database. We studied all patients with confirmed COVID-19 and stroke diagnoses from March 2 Of 2050 patients with confirmed SARS-CoV-2 infection, 21 (1.02%) presented an acute ischemic stroke 21 and 4 (0.2%) suffered an intracranial hemorrhage. After the diagnostic work-up, in 60.0% ischemic and all hemorrhagic strokes patients an etiology non-related with COVID-19 was identified. Only in 6 patients the stroke cause was considered possibly related to COVID-19, all of them required mechanical ventilation before stroke onset. Ten patients underwent endovascular treatment; compared with patients who underwent EVT in the same period, COVID-19 was an independent predictor of in-hospital mortality (50% versus 15%; Odds Ratio, 6.67; 95% CI, 1.1-40.4; p 0.04). The presence of acute stroke in patients with COVID-19 was below 2% and most of them previously presented established stroke risk factors. Without other potential cause, stroke was an uncommon complication and exclusive of patients with a severe pulmonary injury. The presence of COVID-19 in patients who underwent EVT was an independent predictor of in-hospital mortality.
Sections du résumé
BACKGROUND
BACKGROUND
An increased rate of thrombotic events has been associated to Coronavirus Disease 19 (COVID-19) with a variable rate of acute stroke. Our aim is to uncover the rate of acute stroke in COVID-19 patients and identify those cases in which a possible causative relationship could exist.
METHODS
METHODS
We performed a single-center analysis of a prospective mandatory database. We studied all patients with confirmed COVID-19 and stroke diagnoses from March 2
RESULTS
RESULTS
Of 2050 patients with confirmed SARS-CoV-2 infection, 21 (1.02%) presented an acute ischemic stroke 21 and 4 (0.2%) suffered an intracranial hemorrhage. After the diagnostic work-up, in 60.0% ischemic and all hemorrhagic strokes patients an etiology non-related with COVID-19 was identified. Only in 6 patients the stroke cause was considered possibly related to COVID-19, all of them required mechanical ventilation before stroke onset. Ten patients underwent endovascular treatment; compared with patients who underwent EVT in the same period, COVID-19 was an independent predictor of in-hospital mortality (50% versus 15%; Odds Ratio, 6.67; 95% CI, 1.1-40.4; p 0.04).
CONCLUSIONS
CONCLUSIONS
The presence of acute stroke in patients with COVID-19 was below 2% and most of them previously presented established stroke risk factors. Without other potential cause, stroke was an uncommon complication and exclusive of patients with a severe pulmonary injury. The presence of COVID-19 in patients who underwent EVT was an independent predictor of in-hospital mortality.
Identifiants
pubmed: 33066917
pii: S1052-3057(20)30643-1
doi: 10.1016/j.jstrokecerebrovasdis.2020.105225
pmc: PMC7405833
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
105225Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
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