The Effects of COVID-19 on Patients with Acute Ischemic and Hemorrhagic Stroke.

OBJECTIVE: The objective of this study was to evaluate how COVID-19 affects patients with acute ischemic or hemorrhagic stroke outcome. MATERIALS AND METHODS: This retrospective study was performed on adult patients (> 18 years old) with stroke (ischemic or hemorrhagic) who were admitted to hospital with or without COVID-19. The primary outcome was stroke-related disability, which was measured by mRS at baseline and discharge. Hospital duration, intensive care unit (ICU) admission, and mortality were considered the secondary outcomes. RESULTS: From February 2019 until August 2020, we recruited and analyzed 151 patients, 42 of whom had COVID-19 based on RT-PCR tests or lung CT scan findings. COVID-19 positive patients had higher baseline and final mRS scores than the control group (4.46 ± 0.67 vs 4.79 ± 0.61, P: 0.001, 3.83 ± 1.22 vs 4.46 ± 0.67, P: 0.001). Moreover, stroke patients with COVID-19 experienced a more severe disease and required a higher rate of ICU admission (17 vs 0, P:0.001) and longer hospitalization compared to those without COVID-19 (8.50 ± 7.86 vs 7.5 ± 11.20, P: 0.021). Also, mortality was higher in the COVID-19 group (19 vs 13, P:0.001). There was not any significant differences between the two groups in terms of the involvement of cerebral arteries and type of stroke. Male sex, COVID-19, and ICU admission were the main independent risk factors for death. CONCLUSION: The results of the study showed stroke patients (ischemic or hemorrhagic) with COVID-19 can have more disabilities and incur more hospital complications and mortality than non-COVID-19 patients.

The relationship of serum lipid profiles and obesity with the severity of carpal tunnel syndrome.

INTRODUCTION: Carpal tunnel syndrome (CTS) is a prominent compressive neuropathy. There are a number of risk factors for creating CTS but the effect of these factors on the severity of CTS is unclear. In this study, we aimed to assess the correlation of serum lipid profile and obesity with the severity of CTS. METHODS: this cross-sectional study was conducted on 118 patients with idiopathic CTS. Blood samples were obtained for determining the serum levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL-C), and high-density lipoprotein (HDL-C) after 12 hours of overnight fasting. The participants were then divided into two groups of normal and abnormal serum lipids. Body mass index ≥ 30 kg/m2 was considered as obesity. The severity of CTS was determined based on the electrophysiological results and Boston CTS Questionnaire (BCTSQ) that evaluates symptoms severity (SSS) and functional status (FSS) of patients. RESULTS: out of 118 participants, 108 patients performed lipid profile test that 41.17%, 50.42%, 25.21%, and 20.16% of them had TC ≥ 200, TG ≥ 150, LDL-C ≥ 130, and HDL-C < 60 milligrams per deciliter (mg/dl), respectively. The mean scores of SSS in patients with dyslipidemia including the high level of TC, TG, LDL-C, and low level of LDL-C were 34.59±7.86, 34.05±8.73, 34.93±8.21, and 33.48±7.56, respectively. There was no significant association between lipid profile and the symptom severity scale of CTS (p-value > 0.05). The mean BMI of participants was 31.35±5.35 kg/m2, and 58.5% of them had a BMI ≥ 30 kg/m2. The mean score of SSS and FSS was 33.18±8.24 and 24.43±7.12 in obese patients (BMI ≥ 30 kg/m2), and was 34.06±7.85 and 23.06±7.67 in patients with BMI < 30 kg/m2. We found no significant association between obesity with the SSS and FSS (p-value = 0.53 and 0.32, respectively). In terms of the relationship between electrophysiological grading with obesity, 44 (63.8%) of patients with BMI ≥ 30 kg/m2 and 22 (45.8%) patients with BMI < 30 kg/m2 had severe to extreme severe CTS. There was no significant association between obesity and the severity of CTS (p-value = 0.054). CONCLUSION: the results of this study did not demonstrate an association between serum lipid profile and obesity with the severity of carpal tunnel syndrome. The findings of this study may not be extrapolated to other populations. Further studies with more samples are needed to investigate this association.