Impact of COVID-19 Infection on the Outcome of Patients With Ischemic Stroke

Background and Purpose: We evaluated whether stroke severity, functional outcome, and mortality are different in patients with ischemic stroke with or without coronavirus disease 2019 (COVID-19) infection. Methods: A prospective, observational, multicentre cohort study in Catalonia, Spain. Recruitme...

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Detalles Bibliográficos
Autores: Marti-Fabregas, J, Guisado-Alonso, D, Delgado-Mederos, R, Martinez-Domeno, A, Prats-Sanchez, L, Guasch-Jimenez, M, Cardona, P, Nunez-Guillen, A, Requena, M, Rubiera, M, Olive, M, Bustamante, A, Gomis, M, Amaro, S, Llull, L, Ustrell, X, de Oliveira, GC, Sero, L, Gomez-Choco, M, Mena, L, Serena, J, Viturro, SB, Purroy, F, Vicente, M, Rodriguez-Campello, A, Ois, A, Catena, E, Garcia-Carreira, MC, Barrachina, O, Palomeras, E, Krupinski, J, Almeria, M, Zaragoza, J, Esteve, P, Cocho, D, Moreira, A, van Eendenburg, C, Codas, JE, de la Ossa, NP, Salvat, M, Camps-Renom, P
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repositorio:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p1910
Acceso en línea:https://i3pt.portalinvestigacion.com/publicaciones/1910
Access Level:acceso abierto
Palabra clave:cerebrovascular disease
coronavirus
pandemics
prognosis
reperfusion
stroke
thrombectomy
Descripción
Sumario:Background and Purpose: We evaluated whether stroke severity, functional outcome, and mortality are different in patients with ischemic stroke with or without coronavirus disease 2019 (COVID-19) infection. Methods: A prospective, observational, multicentre cohort study in Catalonia, Spain. Recruitment was consecutive from mid-March to mid-May 2020. Patients had an acute ischemic stroke within 48 hours and a previous modified Rankin Scale (mRS) score of 0 to 3. We collected demographic data, vascular risk factors, prior mRS score, National Institutes of Health Stroke Scale score, rate of reperfusion therapies, logistics, and metrics. Primary end point was functional outcome at 3 months. Favourable outcome was defined depending on the previous mRS score. Secondary outcome was mortality at 3 months. We performed mRS shift and multivariable analyses. Results: We evaluated 701 patients (mean age 72.3 +/- 13.3 years, 60.5% men) and 91 (13%) had COVID-19 infection. Median baseline National Institutes of Health Stroke Scale score was higher in patients with COVID-19 compared with patients without COVID-19 (8 [3-18] versus 6 [2-14], P=0.049). Proportion of patients with a favourable functional outcome was 33.7% in the COVID-19 and 47% in the non-COVID-19 group. However, after a multivariable logistic regression analysis, COVID-19 infection did not increase the probability of unfavourable functional outcome. Mortality rate was 39.3% among patients with COVID-19 and 16.1% in the non-COVID-19 group. In the multivariable logistic regression analysis, COVID-19 infection was a risk factor for mortality (hazard ratio, 3.14 [95% CI, 2.10-4.71]; P<0.001). Conclusions: Patients with ischemic stroke and COVID-19 infection have more severe strokes and a higher mortality than patients with stroke without COVID-19 infection. However, functional outcome is comparable in both groups.

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