Characteristics and Outcomes in Patients With COVID-19 and Acute Ischemic Stroke

  • George Ntaios
    Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece (G.N.).
  • Patrik Michel
    Stroke Center, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital, Switzerland (P.M., E.M., D. Strambo).
  • Georgios Georgiopoulos
    School of Biomedical Engineering and Imaging Sciences, King’s College, London, United Kingdom (G.G.).
  • Yutao Guo
    Department of Cardiology, Chinese PLA General Hospital, Beijing, China (Y.G.).
  • Wencheng Li
    Department of Urology (W.L.), Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, China.
  • Jing Xiong
    Department of Nephrology (J.X.), Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, China.
  • Patricia Calleja
    Department of Neurology and Stroke Center, Doce de Octubre University Hospital, Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid, Spain (P.C., F.O., G.G.-O.).
  • Fernando Ostos
    Department of Neurology and Stroke Center, Doce de Octubre University Hospital, Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid, Spain (P.C., F.O., G.G.-O.).
  • Guillermo González-Ortega
    Department of Neurology and Stroke Center, Doce de Octubre University Hospital, Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid, Spain (P.C., F.O., G.G.-O.).
  • Blanca Fuentes
    Department of Neurology and Stroke Center, La Paz University Hospital, IdiPAZ Health Research Institute, Madrid, Spain (B.F., M.A.d.L., E.D.-T.).
  • María Alonso de Leciñana
    Department of Neurology and Stroke Center, La Paz University Hospital, IdiPAZ Health Research Institute, Madrid, Spain (B.F., M.A.d.L., E.D.-T.).
  • Exuperio Díez-Tejedor
    Department of Neurology and Stroke Center, La Paz University Hospital, IdiPAZ Health Research Institute, Madrid, Spain (B.F., M.A.d.L., E.D.-T.).
  • Sebastian García-Madrona
    Department of Neurology and Stroke Centre, Ramón y Cajal University Hospital, IRYCIS Health Research Institute, Madrid, Spain (S.G.-M., J.M., A.D.).
  • Jaime Masjuan
    Department of Neurology and Stroke Centre, Ramón y Cajal University Hospital, IRYCIS Health Research Institute, Madrid, Spain (S.G.-M., J.M., A.D.).
  • Alicia DeFelipe
    Department of Neurology and Stroke Centre, Ramón y Cajal University Hospital, IRYCIS Health Research Institute, Madrid, Spain (S.G.-M., J.M., A.D.).
  • Guillaume Turc
    Department of Neurology, GHU Paris Psychiatrie et Neurosciences, Université de Paris, INSERM U1266, and FHU Neurovasc, France (G.T., B.G., V.D.).
  • Bruno Gonçalves
    Department of Neurology, GHU Paris Psychiatrie et Neurosciences, Université de Paris, INSERM U1266, and FHU Neurovasc, France (G.T., B.G., V.D.).
  • Valerie Domigo
    Department of Neurology, GHU Paris Psychiatrie et Neurosciences, Université de Paris, INSERM U1266, and FHU Neurovasc, France (G.T., B.G., V.D.).
  • Gheorghe-Andrei Dan
    Colentina University Hospital, Medicine Faculty, University of Medicine “Carol Davila”-Bucharest, Romania (G.-A.D., R.V.).
  • Roxana Vezeteu
    Colentina University Hospital, Medicine Faculty, University of Medicine “Carol Davila”-Bucharest, Romania (G.-A.D., R.V.).
  • Hanne Christensen
    Bispebjerg Hospital & University of Copenhagen, Denmark (H.C., L.M.C., P.M., L.H.).
  • Louisa Marguerite Christensen
    Bispebjerg Hospital & University of Copenhagen, Denmark (H.C., L.M.C., P.M., L.H.).
  • Per Meden
    Bispebjerg Hospital & University of Copenhagen, Denmark (H.C., L.M.C., P.M., L.H.).
  • Lejla Hajdarevic
    Bispebjerg Hospital & University of Copenhagen, Denmark (H.C., L.M.C., P.M., L.H.).
  • Angela Rodriguez-Lopez
    Vascular Neurology Section - Stroke Center, Hospital General Universitario Gregorio Marañón, Madrid, Spain (A.R.L., F.D.O., A.G.P., A.G.-N.).
  • Fernando Díaz-Otero
    Vascular Neurology Section - Stroke Center, Hospital General Universitario Gregorio Marañón, Madrid, Spain (A.R.L., F.D.O., A.G.P., A.G.-N.).
  • Andrés García-Pastor
    Vascular Neurology Section - Stroke Center, Hospital General Universitario Gregorio Marañón, Madrid, Spain (A.R.L., F.D.O., A.G.P., A.G.-N.).
  • Antonio Gil-Nuñez
    Vascular Neurology Section - Stroke Center, Hospital General Universitario Gregorio Marañón, Madrid, Spain (A.R.L., F.D.O., A.G.P., A.G.-N.).
  • Errikos Maslias
    Stroke Center, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital, Switzerland (P.M., E.M., D. Strambo).
  • Davide Strambo
    Stroke Center, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital, Switzerland (P.M., E.M., D. Strambo).
  • David J. Werring
    Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, United Kingdom (D.J.W., A.C., L.B., R.S., R.P., R.B.).
  • Arvind Chandratheva
    Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, United Kingdom (D.J.W., A.C., L.B., R.S., R.P., R.B.).
  • Laura Benjamin
    Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, United Kingdom (D.J.W., A.C., L.B., R.S., R.P., R.B.).
  • Robert Simister
    Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, United Kingdom (D.J.W., A.C., L.B., R.S., R.P., R.B.).
  • Richard Perry
    Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, United Kingdom (D.J.W., A.C., L.B., R.S., R.P., R.B.).
  • Rahma Beyrouti
    Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, United Kingdom (D.J.W., A.C., L.B., R.S., R.P., R.B.).
  • Pascal Jabbour
    Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA (P.J., A.S., S.T.).
  • Ahmad Sweid
    Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA (P.J., A.S., S.T.).
  • Stavropoula Tjoumakaris
    Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA (P.J., A.S., S.T.).
  • Elisa Cuadrado-Godia
    Stroke Unit, Department of Neurology, Hospital del Mar (E.C.-G., A.R.C., J.R.).
  • Ana Rodríguez Campello
    Stroke Unit, Department of Neurology, Hospital del Mar (E.C.-G., A.R.C., J.R.).
  • Jaume Roquer
    Stroke Unit, Department of Neurology, Hospital del Mar (E.C.-G., A.R.C., J.R.).
  • Tiago Moreira
    Department of Clinical Neuroscience (T.M., M.V.M.), Karolinska Institutet, Stockholm, Sweden.
  • Michael V. Mazya
    Department of Clinical Neuroscience (T.M., M.V.M.), Karolinska Institutet, Stockholm, Sweden.
  • Fabio Bandini
    Department of Neurology, San Paolo Hospital, Savona, Italy (F.B.).
  • Karl Matz
    Landesklinikum Mödling, Neurologische Abteilung und Donau-Universität Krems, Zentrum für Vaskuläre Prävention, Krems, Austria (K.M.).
  • Helle K. Iversen
    Stroke Centre Rigshospitalet, Department of Neurology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (H.K.I.).
  • Alejandra González-Duarte
    Department of Neurology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, a COVID Center, Mexico City (A.G.-D.).
  • Cristina Tiu
    Carol Davila University of Medicine and Pharmacy, Bucharest, Romania (C.T.).
  • Julia Ferrari
    Department of Neurology, Krankenhaus Barmherzige Brüder, Vienna, Austria (J.F.).
  • Milan R. Vosko
    Department of Neurology 2 (M.R.V.), Kepler University Hospital, Linz, Austria.
  • Helmut J.F. Salzer
    Department of Pulmonary Medicine (H.J.F.S., B.L.), Kepler University Hospital, Linz, Austria.
  • Bernd Lamprecht
    Department of Pulmonary Medicine (H.J.F.S., B.L.), Kepler University Hospital, Linz, Austria.
  • Martin W. Dünser
    Department of Anesthesiology and Intensive Care Medicine, Johannes Kepler University, Linz, Austria (M.W.D.).
  • Carlo W. Cereda
    Stroke Center EOC, Neurocenter of Southern Switzerland, Lugano (C.W.C.).
  • Ángel Basilio Corredor Quintero
    Department of Neurology, Hospital Departamental Universitario del Quindío San Juan de DiosArmenia, Colombia (Á.B.C.Q.).
  • Eleni Korompoki
    Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Greece (E.K.).
  • Eduardo Soriano-Navarro
    Internal Medicine, Fundación Clínica Médica Sur, Mexico City (E.S.-N., L.E.S.-R., P.F.C.-M., D.B.-S.).
  • Luis Enrique Soto-Ramírez
    Internal Medicine, Fundación Clínica Médica Sur, Mexico City (E.S.-N., L.E.S.-R., P.F.C.-M., D.B.-S.).
  • Paulo F. Castañeda-Méndez
    Internal Medicine, Fundación Clínica Médica Sur, Mexico City (E.S.-N., L.E.S.-R., P.F.C.-M., D.B.-S.).
  • Daniela Bay-Sansores
    Internal Medicine, Fundación Clínica Médica Sur, Mexico City (E.S.-N., L.E.S.-R., P.F.C.-M., D.B.-S.).
  • Antonio Arauz
    Stroke Clinic, Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico City (A.A., V.C.-N.).
  • Vanessa Cano-Nigenda
    Stroke Clinic, Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico City (A.A., V.C.-N.).
  • Espen Saxhaug Kristoffersen
    Department of Neurology, Akershus University Hospital, Norway (E.S.K.).
  • Marjaana Tiainen
    Department of Neurology, Helsinki University Hospital, Finland (M.T., D. Strbian, J.P.).
  • Daniel Strbian
    Department of Neurology, Helsinki University Hospital, Finland (M.T., D. Strbian, J.P.).
  • Jukka Putaala
    Department of Neurology, Helsinki University Hospital, Finland (M.T., D. Strbian, J.P.).
  • Gregory Y.H. Lip
    Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, United Kingdom (G.Y.H.L.).

書誌事項

タイトル別名
  • The Global COVID-19 Stroke Registry

抄録

<jats:p> Recent case-series of small size implied a pathophysiological association between coronavirus disease 2019 (COVID-19) and severe large-vessel acute ischemic stroke. Given that severe strokes are typically associated with poor prognosis and can be very efficiently treated with recanalization techniques, confirmation of this putative association is urgently warranted in a large representative patient cohort to alert stroke clinicians, and inform pre- and in-hospital acute stroke patient pathways. We pooled all consecutive patients hospitalized with laboratory-confirmed COVID-19 and acute ischemic stroke in 28 sites from 16 countries. To assess whether stroke severity and outcomes (assessed at discharge or at the latest assessment for those patients still hospitalized) in patients with acute ischemic stroke are different between patients with COVID-19 and non-COVID-19, we performed 1:1 propensity score matching analyses of our COVID-19 patients with non-COVID-19 patients registered in the Acute Stroke Registry and Analysis of Lausanne Registry between 2003 and 2019. Between January 27, 2020, and May 19, 2020, 174 patients (median age 71.2 years; 37.9% females) with COVID-19 and acute ischemic stroke were hospitalized (median of 12 patients per site). The median National Institutes of Health Stroke Scale was 10 (interquartile range [IQR], 4–18). In the 1:1 matched sample of 336 patients with COVID-19 and non-COVID-19, the median National Institutes of Health Stroke Scale was higher in patients with COVID-19 (10 [IQR, 4–18] versus 6 [IQR, 3–14]), <jats:italic>P</jats:italic> =0.03; (odds ratio, 1.69 [95% CI, 1.08–2.65] for higher National Institutes of Health Stroke Scale score). There were 48 (27.6%) deaths, of which 22 were attributed to COVID-19 and 26 to stroke. Among 96 survivors with available information about disability status, 49 (51%) had severe disability at discharge. In the propensity score-matched population (n=330), patients with COVID-19 had higher risk for severe disability (median mRS 4 [IQR, 2–6] versus 2 [IQR, 1–4], <jats:italic>P</jats:italic> <0.001) and death (odds ratio, 4.3 [95% CI, 2.22–8.30]) compared with patients without COVID-19. Our findings suggest that COVID-19 associated ischemic strokes are more severe with worse functional outcome and higher mortality than non-COVID-19 ischemic strokes. </jats:p>

収録刊行物

  • Stroke

    Stroke 51 (9), 2020-09

    Ovid Technologies (Wolters Kluwer Health)

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