Acute ischaemic stroke associated with SARS-CoV-2 infection in North America.
J Neurol Neurosurg Psychiatry
; 93(4): 360-368, 2022 04.
Article
em En
| MEDLINE
| ID: mdl-35078916
ABSTRACT
BACKGROUND:
To analyse the clinical characteristics of COVID-19 with acute ischaemic stroke (AIS) and identify factors predicting functional outcome.METHODS:
Multicentre retrospective cohort study of COVID-19 patients with AIS who presented to 30 stroke centres in the USA and Canada between 14 March and 30 August 2020. The primary endpoint was poor functional outcome, defined as a modified Rankin Scale (mRS) of 5 or 6 at discharge. Secondary endpoints include favourable outcome (mRS ≤2) and mortality at discharge, ordinal mRS (shift analysis), symptomatic intracranial haemorrhage (sICH) and occurrence of in-hospital complications.RESULTS:
A total of 216 COVID-19 patients with AIS were included. 68.1% (147/216) were older than 60 years, while 31.9% (69/216) were younger. Median [IQR] National Institutes of Health Stroke Scale (NIHSS) at presentation was 12.5 (15.8), and 44.2% (87/197) presented with large vessel occlusion (LVO). Approximately 51.3% (98/191) of the patients had poor outcomes with an observed mortality rate of 39.1% (81/207). Age >60 years (aOR 5.11, 95% CI 2.08 to 12.56, p<0.001), diabetes mellitus (aOR 2.66, 95% CI 1.16 to 6.09, p=0.021), higher NIHSS at admission (aOR 1.08, 95% CI 1.02 to 1.14, p=0.006), LVO (aOR 2.45, 95% CI 1.04 to 5.78, p=0.042), and higher NLR level (aOR 1.06, 95% CI 1.01 to 1.11, p=0.028) were significantly associated with poor functional outcome.CONCLUSION:
There is relationship between COVID-19-associated AIS and severe disability or death. We identified several factors which predict worse outcomes, and these outcomes were more frequent compared to global averages. We found that elevated neutrophil-to-lymphocyte ratio, rather than D-Dimer, predicted both morbidity and mortality.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Isquemia Encefálica
/
Acidente Vascular Cerebral
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AVC Isquêmico
/
COVID-19
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
/
Middle aged
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article