ABSTRACT
Background@#and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. @*Methods@#We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). @*Results@#There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. @*Conclusions@#During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.
ABSTRACT
To assess the clinical relevance [functional outcome] of a 3-month allopurinol regimen in patients with high serum uric acid [SUA] levels and acute ischemic stroke without considering the changes in SUA levels. In a randomized, double-blind, controlled study, 70 patients [45 females, 25 males] with acute ischemic stroke who had elevated levels of SUA were included. They were divided in two 35-patient groups to investigate the effect of 3 months of an allopurinol [200 mg/day] regimen versus placebo on their functional outcome, which was evaluated using a modified Rankin scale. The overall mean age was 68.9 +/- 11.33 years [range 27-89]. The final favorable functional status [mRS = 0-2] was 23 [65.7%] and 14 [40.0%] in the treated and placebo groups, respectively, which was strongly associated with allopurinol consumption [OR = 4.646, p = 0.014] and age
Subject(s)
Humans , Female , Male , Stroke , Uric Acid/blood , Acute Disease , Double-Blind Method , Xanthine Oxidase/antagonists & inhibitorsABSTRACT
Several reports concern the relationship between low dose oral contraceptive pills [OCP] and the occurrence of strokes. The present study investigates this relationship in childbearing stroke women admitted to university referral hospitals in North-West Iran. One hundred seventy eight female patients between 15 and 44 years of age who were admitted to two referral University Hospitals in a six years period were evaluated in this descriptive-analytical study. Data concerning the use of OCP and other risk factors were recorded. The OCP usage data were compared between the patients and the matched normal population. The average age of the patients was 35.5 +/- 7.4 years. Seventy three patients were admitted with arterial stroke, 15 patients had cardioembolic origin, 39 patients with venous stroke and 46 patients with hemorrhagic stroke, 45.2%, 20%, 59% and 30.4% of them used OCP respectively. Approximately 26.3% of the matched female population of childbearing age used OCP and there was a significant correlation between venous stroke [P < 0.0001] and atherothrombotic stroke [P < 0.0001] with OCP usage. Migraine was the only risk factor that significantly correlated with OCP consumption and stroke. In addition, the data concerning OCP use in the stroke patients, without any other risk factors [32/71: 45%], demonstrated a significant difference comparing the matched population [P < 0.0001]. OCP usage increases the risk of venous and atherothrombotic stroke in North-West of Iran, particularly in those individuals who suffer concurrent migraine