Journal article
Acute ischaemic stroke associated with SARS-CoV-2 infection in North America
Journal of neurology, neurosurgery and psychiatry, Vol.93(4), pp.360-368
01/25/2022
DOI: 10.1136/jnnp-2021-328354
PMID: 35078916
Abstract
BackgroundTo analyse the clinical characteristics of COVID-19 with acute ischaemic stroke (AIS) and identify factors predicting functional outcome.MethodsMulticentre 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.ResultsA 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.ConclusionThere 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.
Details
- Title: Subtitle
- Acute ischaemic stroke associated with SARS-CoV-2 infection in North America
- Creators
- Adam A Dmytriw - Massachusetts General HospitalMahmoud Dibas - Brigham and Women's HospitalKevin Phan - Brigham and Women's HospitalAslan Efendizade - Kings County Hospital CenterJohanna Ospel - Calgary Stroke Program, Cumming School of Medicine, Calgary, AB, CanadaClemens Schirmer - Geisinger Neuroscience InstituteFabio Settecase - Vancouver General HospitalManraj K S Heran - Vancouver General HospitalAnna Luisa Kühn - UMass Memorial Health CareAjit S Puri - UMass Memorial Health CareBijoy K Menon - University of CalgarySanjeev Sivakumar - Prisma HealthAskan Mowla - Department of Neurological Surgery, USC Keck School of Medicine, Los Angeles, CA, USADaniel Vela-Duarte - Neuroradiology & Neurology Services, Miami Baptist Medical Center, Miami, FL, USAItalo Linfante - Neuroradiology & Neurology Services, Miami Baptist Medical Center, Miami, FL, USAGuilherme C Dabus - Neuroradiology & Neurology Services, Miami Baptist Medical Center, Miami, FL, USARobert W Regenhardt - Massachusetts General HospitalSalvatore D'Amato - Brigham and Women's HospitalJoseph A Rosenthal - Brigham and Women's HospitalAlicia Zha - The University of Texas Health Science Center at HoustonNafee Talukder - The University of Texas Health Science Center at HoustonSunil A Sheth - The University of Texas Health Science Center at HoustonAmeer E Hassan - Valley Baptist Medical CenterDaniel L Cooke - Department of Neurointerventional Radiology, University California San Francisco, San Francisco, CA, USALester Y Leung - Tufts Medical CenterAdel M Malek - Tufts Medical CenterBarbara Voetsch - Lahey Hospital and Medical CenterSiddharth Sehgal - Lahey Hospital and Medical CenterAjay K Wakhloo - Lahey Hospital and Medical CenterMayank Goyal - University of CalgaryHannah Wu - Brookdale University Hospital and Medical CenterJake Cohen - Brookdale University Hospital and Medical CenterSherief Ghozy - Brigham and Women's HospitalDavid Turkel-Parella - Brookdale University Hospital and Medical CenterZerwa Farooq - Kings County Hospital CenterJustin E Vranic - Massachusetts General HospitalJames D Rabinov - Massachusetts General HospitalChristopher J Stapleton - Massachusetts General HospitalRamandeep Minhas - Kings County Hospital CenterVinodkumar Velayudhan - Kings County Hospital CenterZeshan Ahmed Chaudhry - Kings County Hospital CenterAndrew Xavier - Sinai Grace HospitalMaria Bres Bullrich - London Health Sciences CentreSachin Pandey - London Health Sciences CentreLuciano A Sposato - London Health Sciences CentreStephen A Johnson - Robert Wood Johnson University HospitalGaurav Gupta - Departments of Neurology & Neurosurgery, Robert Wood Johnson University Hospital, New Brunswick, NJ, USAPriyank Khandelwal - Robert Wood Johnson University HospitalLatisha Ali - University of California, Los AngelesDavid S Liebeskind - University of California, Los AngelesMudassir Farooqui - University of IowaSantiago Ortega-Gutierrez - University of IowaFadi Nahab - Emory UniversityDinesh V Jillella - Emory UniversityKaren Chen - Brigham and Women's HospitalMohammad Ali Aziz-Sultan - Brigham and Women's HospitalMohamad Abdalkader - Boston Medical CenterArtem Kaliaev - Boston Medical CenterThanh N Nguyen - Boston Medical CenterDiogo C Haussen - Grady Memorial HospitalRaul G Nogueira - Grady Memorial HospitalIsrar Ul Haq - Bon Secours Mercy HealthOsama O Zaidat - Saint Vincent Health SystemEmma Sanborn - Cooper University HospitalThabele M Leslie-Mazwi - Massachusetts General HospitalAman B Patel - Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USAJames E Siegler - Cooper University HospitalAmbooj Tiwari - Brookdale University Hospital and Medical CenterNorth American Neurovascular COVID-19 (NAN-C) ConsortiumSociety of Vascular and Interventional Neurology (SVIN) Investigators
- Resource Type
- Journal article
- Publication Details
- Journal of neurology, neurosurgery and psychiatry, Vol.93(4), pp.360-368
- DOI
- 10.1136/jnnp-2021-328354
- PMID
- 35078916
- NLM abbreviation
- J Neurol Neurosurg Psychiatry
- ISSN
- 0022-3050
- eISSN
- 1468-330X
- Publisher
- BMJ Publishing Group Ltd
- Language
- English
- Date published
- 01/25/2022
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984303025502771
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