Search | WHO COVID-19 Research Database

1.

Global impact of the COVID-19 pandemic on stroke care and intravenous thrombolysis

Nguyen, T.; Qureshi, M.; Martins, S.; Yamagami, H.; Qiu, Z.; Mansour, O.; Czlonkowska, A.; Abdalkader, M.; Sathya, A.; de Sousa, D. A.; Demeestere, J.; Mikulik, R.; Vanacker, P.; Siegler, J.; Korv, J.; Biller, J.; Liang, C.; Sangha, N.; Zha, A.; Czap, A.; Holmstedt, C.; Turan, T.; Grant, C.; Ntaios, G.; Malhotra, K.; Tayal, A.; Loochtan, A.; Mistry, E.; Alexandrov, A.; Huang, D.; Yaghi, S.; Raz, E.; Sheth, S.; Frankel, M.; Lamou, E. G. B.; Aref, H.; Elbassiouny, A.; Hassan, F.; Mustafa, W.; Menecie, T.; Shokri, H.; Roushdy, T.; Sarfo, F. S.; Alabi, T.; Arabambi, B.; Nwazor, E.; Sunmonu, T. A.; Wahab, K. W.; Mohammed, H. H.; Adebayo, P. B.; Riahi, A.; Ben Sassi, S.; Gwaunza, L.; Rahman, A.; Ai, Z. B.; Bai, F. H.; Duan, Z. H.; Hao, Y. G.; Huang, W. G.; Li, G. W.; Li, W.; Liu, G. Z.; Luo, J.; Shang, X. J.; Sui, Y.; Tian, L.; Wen, H. B.; Wu, B.; Yan, Y. Y.; Yuan, Z. Z.; Zhang, H.; Zhang, J.; Zhao, W. L.; Zi, W. J.; Leung, T. K.; Sahakyan, D.; Chugh, C.; Huded, V.; Menon, B.; Pandian, J.; Sylaja, P. N.; Usman, F. S.; Farhoudi, M.; Sadeghi-Hokmabadi, E.; Reznik, A.; Sivan-Hoffman, R.; Horev, A.; Ohara, N.; Sakai, N.; Watanabe, D.; Yamamoto, R.; Doijiri, R.; Tokuda, N.; Yamada, T.; Terasaki, T.; Yazawa, Y.; Uwatoko, T.; Dembo, T.; Shimizu, H.; Sugiura, Y.; Miyashita, F.; Fukuda, H.; Miyake, K.; Shimbo, J.; Sugimura, Y.; Yagita, Y.; Takenobu, Y.; Matsumaru, Y.; Yamada, S.; Kono, R.; Kanamaru, T.; Yamazaki, H.; Sakaguchi, M.; Todo, K.; Yamamoto, N.; Sonodda, K.; Yoshida, T.; Hashimoto, H.; Nakahara, I.; Faizullina, K.; Kamenova, S.; Kondybayeva, A.; Zhanuzakov, M.; Baek, J. H.; Hwang, Y.; Lee, S. B.; Moon, J.; Park, H.; Seo, J. H.; Seo, K. D.; Young, C. J.; Ahdab, R.; Aziz, Z. A.; Zaidi, W. A. W.; Bin Basri, H.; Chung, L. W.; Husin, M.; Ibrahim, A. B.; Ibrahim, K. A.; Looi, I.; Tan, W. Y.; Yahya, Wnnw, Groppa, S.; Leahu, P.; Al Hashmi, A.; Imam, Y. Z.; Akhtar, N.; Oliver, C.; Kandyba, D.; Alhazzani, A.; Al-Jehani, H.; Tham, C. H.; Mamauag, M. J.; Narayanaswamy, R.; Chen, C. H.; Tang, S. C.; Churojana, A.; Aykac, O.; Ozdemir, A. O.; Hussain, S. I.; John, S.; Vu, H. L.; Tran, A. D.; Nguyen, H. H.; Thong, P. N.; Nguyen, T.; Nguyen, T.; Gattringer, T.; Enzinger, C.; Killer-Oberpfalzer, M.; Bellante, F.; De Blauwe, S.; Van Hooren, G.; De Raedt, S.; Dusart, A.; Ligot, N.; Rutgers, M.; Yperzeele, L.; Alexiev, F.; Sakelarova, T.; Bedekovic, M. R.; Budincevic, H.; Cindric, I.; Hucika, Z.; Ozretic, D.; Saric, M. S.; Pfeifer, F.; Karpowicz, I.; Cernik, D.; Sramek, M.; Skoda, M.; Hlavacova, H.; Klecka, L.; Koutny, M.; Vaclavik, D.; Skoda, O.; Fiksa, J.; Hanelova, K.; Nevsimalova, M.; Rezek, R.; Prochazka, P.; Krejstova, G.; Neumann, J.; Vachova, M.; Brzezanski, H.; Hlinovsky, D.; Tenora, D.; Jura, R.; Jurak, L.; Novak, J.; Novak, A.; Topinka, Z.; Fibrich, P.; Sobolova, H.; Volny, O.; Christensen, H. K.; Drenck, N.; Iversen, H.; Simonsen, C.; Truelsen, T.; Wienecke, T.; Vibo, R.; Gross-Paju, K.; Toomsoo, T.; Antsov, K.; Caparros, F.; Cordonnier, C.; Dan, M.; Faucheux, J. M.; Mechtouff, L.; Eker, O.; Lesaine, E.; Ondze, B.; Pico, F.; Pop, R.; Rouanet, F.; Gubeladze, T.; Khinikadze, M.; Lobjanidze, N.; Tsiskaridze, A.; Nagel, S.; Ringleb, P. A.; Rosenkranz, M.; Schmidt, H.; Sedghi, A.; Siepmann, T.; Szabo, K.; Thomalla, G.; Palaiodimou, L.; Sagris, D.; Kargiotis, O.; Kaliaev, A.; Liebeskind, D.; Hassan, A.; Ranta, A.; Devlin, T.; Zaidat, O.; Castonguay, A.; Jovin, T.; Tsivgoulis, G.; Malik, A.; Ma, A.; Campbell, B.; Kleinig, T.; Wu, T.; Gongora, F.; Lavados, P.; Olavarria, V.; Lereis, V. P.; Corredor, A.; Barbosa, D. M.; Bayona, H.; Barrientos, J. D.; Patino, M.; Thijs, V.; Pirson, A.; Kristoffersen, E. S.; Patrik, M.; Fischer, U.; Bernava, G.; Renieri, L.; Strambo, D.; Ayo-Martin, O.; Montaner, J.; Karlinski, M.; Cruz-Culebras, A.; Luchowski, P.; Krastev, G.; Arenillas, J.; Gralla, J.; Mangiafico, S.; Blasco, J.; Fonseca, L.; Silva, M. L.; Kwan, J.; Banerjee, S.; Sangalli, D.; Frisullo, G.; Yavagal, D.; Uyttenboogaart, M.; Bandini, F.; Adami, A.; de Lecina, M. A.; Arribas, M. A. T.; Ferreira, P.; Cruz, V. T.; Nunes, A. P.; Marto, J. P.; Rodrigues, M.; Melo, T.; Saposnik, G.; Scott, C. A.; Shuaib, A.; Khosravani, H.; Fields, T.; Shoamanesh, A.; Catanese, L.; Mackey, A.; Hill, M.; Etherton, M.; Rost, N.; Lutsep, H.; Lee, V.; Mehta, B.; Pikula, A.; Simmons, M.; Macdougall, L.; Silver, B.; Khandelwal, P.; Morris, J.; Novakovic-White, R.; Ramakrishnan, P.; Shah, R.; Altschul, D.; Almufti, F.; Amaya, P.; Ordonez, C. E. R.; Lara, O.; Kadota, L. R.; Rivera, L. I. P.; Novarro, N.; Escobar, L. D.; Melgarejo, D.; Cardozo, A.; Blanco, A.; Zelaya, J. A.; Luraschi, A.; Gonzalez, V. H. N.; Almeida, J.; Conforto, A.; Almeida, M. S.; Silva, L. D.; Cuervo, D. L. M.; Zetola, V. F.; Martins, R. T.; Valler, L.; Giacomini, L. V.; Cardoso, F. B.; Sahathevan, R.; Hair, C.; Hankey, G.; Salazar, D.; Lima, F. O.; Mont'Alverne, F.; Moises, D.; Iman, B.; Magalhaes, P.; Longo, A.; Rebello, L.; Falup-Pecurariu, C.; Mazya, M.; Wisniewska, A.; Fryze, W.; Kazmierski, R.; Wisniewska, M.; Horoch, E.; Sienkiewicz-Jarosz, H.; Fudala, M.; Rogoziewicz, M.; Brola, W.; Sobolewski, P.; Kaczorowski, R.; Stepien, A.; Klivenyi, P.; Szapary, L.; van den Wijngaard, I.; Demchuk, A.; Abraham, M.; Alvarado-Ortiz, T.; Kaushal, R.; Ortega-Gutierrez, S.; Farooqui, M.; Bach, I.; Badruddin, A.; Barazangi, N.; Nguyen, C.; Brereton, C.; Choi, J. H.; Dharmadhikari, S.; Desai, K.; Doss, V.; Edgell, R.; Linares, G.; Frei, D.; Chaturvedi, S.; Gandhi, D.; Chaudhry, S.; Choe, H.; Grigoryan, M.; Gupta, R.; Helenius, J.; Voetsch, B.; Khwaja, A.; Khoury, N.; Kim, B. S.; Kleindorfer, D.; McDermott, M.; Koyfman, F.; Leung, L.; Linfante, I.; Male, S.; Masoud, H.; Min, J. Y.; Mittal, M.; Multani, S.; Nahab, F.; Nalleballe, K.; Rahangdale, R.; Rafael, J.; Rothstein, A.; Ruland, S.; Sharma, M.; Singh, A.; Starosciak, A.; Strasser, S.; Szeder, V.; Teleb, M.; Tsai, J.; Mohammaden, M.; Pineda-Franks, C.; Asyraf, W.; Nguyen, T. Q.; Tarkanyi, G.; Horev, A.; Haussen, D.; Balaguera, O.; Vasquez, A. R.; Nogueira, R..

Neurology ; 96(15):42, 2021.

Article in English | Web of Science | ID: covidwho-1576349

2.

Delay in stroke code timings during the COVID-19 pandemic

Surathi, P.; Gomez, R.; Prasad, N.; Bach, I.; Tofade, T.; Shaulov, S.; Jacob, M.; Kamel, A..

Neurology ; 96(15):2, 2021.

Article in English | Web of Science | ID: covidwho-1576171

3.

Delay in stroke code timings during the COVID- 19 pandemic

Surathi, P.; Gomez, R.; Prasad, N.; Bach, I.; Tofade, T.; Shaulov, S.; Jacob, M.; Kamel, A..

Neurology ; 96(15 SUPPL 1), 2021.

Article in English | EMBASE | ID: covidwho-1407950

ABSTRACT

Objective: This study aims to analyze stroke code timings to determine delays during the Coronavirus Disease 2019 (COVID-19) pandemic compared to the pre-pandemic period. Background: During the pandemic, multiple reports from across the world have suggested that there was a reduction in stroke-related hospitalizations. Further delays in management may have occurred on arrival to the hospital due to the increased patient burden during the pandemic. Design/Methods: All stroke codes and stroke discharges from a comprehensive stroke center in New Jersey between February to April 2020 were included in this study. They were divided into two groups-the pandemic period (3/15/2020 to 4/30/2020) and the pre-pandemic period (2/1/2020 to 3/14/2020). The stroke code timings, including the discovery of symptoms to emergency room (ER) arrival, door to stroke alert times, door to CT times, and door to needle times were compared. Results: There was a total of 183 stroke codes from the ER during this study period, with no significant difference in the number of stroke codes between the two groups. The ER arrival to tPA administration time was 65.4 (±16.5) minutes during the pandemic compared to 44.8 (±17.2) minutes in the pre-pandemic period (P-value = 0.01). Discovery of symptoms to ER arrival (P=0.01), ER arrival to stroke alert time (P=0.0021), and CT scan time (P=0.015) were delayed significantly in patients who had respiratory symptoms. Conclusions: There were significant delays in stroke code timings during the pandemic, which were attributed to both medical and in-hospital reasons. Our study highlights the impact the pandemic has had on the management of stroke. Increasing public awareness that stroke-like symptoms should not be ignored during the pandemic and maintaining a dedicated stroke team in hospitals are necessary.

4.

Global impact of the COVID-19 pandemic on stroke care and intravenous thrombolysis

Nguyen, T.; Qureshi, M.; Martins, S.; Yamagami, H.; Qiu, Z.; Mansour, O.; Czlonkowska, A.; Abdalkader, M.; Sathya, A.; Sousa, D. A.; Demeester, J.; Mikulik, R.; Vanacker, P.; Siegler, J.; Korv, J.; Biller, J.; Liang, C.; Sangha, N.; Zha, A.; Czap, A.; Holmstedt, C.; Turan, T.; Grant, C.; Ntaios, G.; Malhotra, K.; Tayal, A.; Loochtan, A.; Mistry, E.; Alexandrov, A.; Huang, D.; Yaghi, S.; Raz, E.; Sheth, S.; Frankel, M.; Lamou, E. G. B.; Aref, H.; Elbassiouny, A.; Hassan, F.; Mustafa, W.; Menecie, T.; Shokri, H.; Roushdy, T.; Sarfo, F. S.; Alabi, T.; Arabambi, B.; Nwazor, E.; Sunmonu, T. A.; Wahab, K. W.; Mohammed, H. H.; Adebayo, P. B.; Riahi, A.; Sassi, S. B.; Gwaunza, L.; Rahman, A.; Ai, Z.; Bai, F.; Duan, Z.; Hao, Y.; Huang, W.; Li, G.; Li, W.; Liu, G.; Luo, J.; Shang, X.; Sui, Y.; Tian, L.; Wen, H.; Wu, B.; Yan, Y.; Yuan, Z.; Zhang, H.; Zhang, J.; Zhao, W.; Zi, W.; Leung, T. K.; Sahakyan, D.; Chugh, C.; Huded, V.; Menon, B.; Pandian, J.; Sylaja, P. N.; Usman, F. S.; Farhoudi, M.; Sadeghi-Hokmabadi, E.; Reznik, A.; Sivan-Hoffman, R.; Horev, A.; Ohara, N.; Sakai, N.; Watanabe, D.; Yamamoto, R.; Doijiri, R.; Kuda, N.; Yamada, T.; Terasaki, T.; Yazawa, Y.; Uwatoko, T.; Dembo, T.; Shimizu, H.; Sugiura, Y.; Miyashita, F.; Fukuda, H.; Miyake, K.; Shimbo, J.; Sugimura, Y.; Yagita, Y.; Takenobu, Y.; Matsumaru, Y.; Yamada, S.; Kono, R.; Kanamaru, T.; Yamazaki, H.; Sakaguchi, M.; Todo, K.; Yamamoto, N.; Sonodda, K.; Yoshida, T.; Hashimoto, H.; Nakahara, I.; Faizullina, K.; Kamenova, S.; Kondybayev, A.; Zhanuzakov, M.; Baek, J. H.; Hwang, Y.; Lee, S. B.; Moon, J.; Park, H.; Seo, J. H.; Seo, K. D.; Young, C. J.; Ahdab, R.; Aziz, Z. A.; Zaidi, W. A. W.; Basr, H. B.; Chung, L. W.; Husin, M.; Ibrahim, A. B.; Ibrahim, K. A.; Looi, I.; Tan, W. Y.; Yahya, W. N. W.; Groppa, S.; Leahu, P.; Hashmi, A. A.; Imam, Y. Z.; Akhtar, N.; Oliver, C.; Kandyba, D.; Alhazzani, A.; Al-Jehani, H.; Tham, C. H.; Mamauag, M. J.; Narayanaswamy, R.; Chen, C. H.; Tang, S. C.; Churojana, A.; Aykaç, O.; Özdemir, A.; Hussain, S. I.; John, S.; Vu, H. L.; Tran, A. D.; Nguyen, H. H.; Thong, P. N.; Nguyen, T.; Nguyen, T.; Gattringer, T.; Enzinger, C.; Killer-Oberpfalzer, M.; Bellante, F.; Deblauwe, S.; Hooren, G. V.; Raedt, S. D.; Dusart, A.; Ligot, N.; Rutgers, M.; Yperzeele, L.; Alexiev, F.; Sakelarova, T.; Bedekovic, M.; Budincevic, H.; Cindric, I.; Hucika, Z.; Ozretic, D.; Saric, M. S.; Pfeifer, F.; Karpowicz, I.; Cernik, D.; Sramek, M.; Skoda, M.; Hlavacova, H.; Klecka, L.; Koutny, M.; Skoda, O.; Fiksa, J.; Hanelova, K.; Nevsimalova, M.; Rezek, R.; Prochazka, P.; Krejstova, G.; Neumann, J.; Vachova, M.; Brzezanski, H.; Hlinovsky, D.; Tenora, D.; Jura, R.; Jurak, L.; Novak, J.; Novak, A.; Topinka, Z.; Fibrich, P.; Sobolova, H.; Volny, O.; Christensen, H. K.; Drenck, N.; Iversen, H.; Simonsen, C.; Truelsen, T.; Wienecke, T.; Vibo, R.; Gross-Paju, K.; Toomsoo, T.; Antsov, K.; Caparros, F.; Cordonnier, C.; Dan, M.; Faucheux, J. M.; Mechtouff, L.; Eker, O.; Lesaine, E.; Pico, F.; Pop, R.; Rouanet, F.; Gubeladze, T.; Khinikadze, M.; Lobjanidze, N.; Tsiskaridze, A.; Nagel, S.; Arthurringleb, P.; Rosenkranz, M.; Schmidt, H.; Sedghi, A.; Siepmann, T.; Szabo, K.; Thomalla, G.; Palaiodimou, L.; Sagris, D.; Kargiotis, O.; Kaliaev, A.; Liebeskind, D.; Hassan, A.; Ranta, A.; Devlin, T.; Zaidat, O.; Castonguay, A.; Jovin, T.; Tsivgoulis, G.; Malik, A.; Ma, A.; Campbel, B.; Kleinig, T.; Wu, T.; Gongora, F.; Lavados, P.; Olavarria, V.; Lereis, V. P.; Corredor, A.; Barbosa, D. M.; Bayona, H.; Barrientos, J. D.; Patino, M.; Thijs, V.; Pirson, A.; Kristoffersen, E. S.; Patrik, M.; Fischer, U.; Bernava, G.; Renieri, L.; Strambo, D.; Ayo-Martin, O.; Montaner, J.; Karlinski, M.; Cruz-Culebras, A.; Luchowski, P.; Krastev, G.; Arenillas, J.; Gralla, J.; Mangiafico, S.; Blasco, J.; Fonseca, L.; Silva, M. L.; Kwan, J.; Banerjee, S.; Sangalli, D.; Frisullo, G.; Yavagal, D.; Uyttenboogaart, M.; Bandini, F.; Adami, A.; Lecina, M. A. D.; Arribas, M. A. T.; Ferreira, P.; Cruz, V. T.; Nunes, A. P.; Marto, J. P.; Rodrigues, M.; Melo, T.; Saposnik, G.; Scott, C. A.; Shuaib, A.; Khosravani, H.; Fields, T.; Shoamanesh, A.; Catanese, L.; MacKey, A.; Hill, M.; Etherton, M.; Rost, N.; Lutsep, H.; Lee, V.; Mehta, B.; Pikula, A.; Simmons, M.; MacDougall, L.; Silver, B.; Khandelwal, P.; Morris, J.; Novakovic-White, R.; Shah, R.; Altschul, D.; Almufti, F.; Amaya, P.; Ordonez, C. E. R.; Lara, O.; Kadota, L. R.; Rivera, L. I.; Novarro, N.; Escobar, L. D.; Melgarejo, D.; Cardozo, A.; Blanco, A.; Zelaya, J. A.; Luraschi, A.; Gonzalez, V. H.; Almeida, J.; Conforto, A.; Almeida, M. S.; Silva, L. D. D.; Cuervo, D. L. M.; Zetola, V. F.; Martins, R. T.; Valler, L.; Giacomini, L. V.; Buchdidcardoso, F.; Sahathevan, R.; Hair, C.; Hankey, G.; Salazar, D.; Lima, F. O.; Mont'alverne, F.; Iman, D. M. B.; Longo, A.; Rebello, L.; Falup-Pecurariu, C.; Mazya, M.; Wisniewska, A.; Fryze, W.; Kazmierski, R.; Wisniewska, M.; Horoch, E.; Sienkiewicz-Jarosz, H.; Fudala, M.; Goziewicz, M.; Brola, W.; Sobolewski, P.; Kaczorowski, R.; Stepien, A.; Klivenyi, P.; Szapary, L.; Wijngaard, I. V. D.; Demchuk, A.; Abraham, M.; Alvarado-Ortiz, T.; Kaushal, R.; Ortega-Gutierrez, S.; Farooqui, M.; Bach, I.; Badruddin, A.; Barazangi, N.; Nguyen, C.; Brereton, C.; Choi, J. H.; Dharmadhikari, S.; Desai, K.; Doss, V.; Edgell, R.; Linares, G.; Frei, D.; Chaturvedi, S.; Gandhi, D.; Chaudhry, S.; Choe, H.; Grigoryan, M.; Gupta, R.; Helenius, J.; Voetsch, B.; Khwaja, A.; Khoury, N.; Kim, B. S.; Kleindorfer, D.; McDermott, M.; Koyfman, F.; Leung, L.; Linfante, I.; Male, S.; Masoud, H.; Min, J.; Mittal, M.; Multani, S.; Nahab, F.; Nalleballe, K.; Rahangdale, R.; Rafael, J.; Rothstein, A.; Ruland, S.; Sharma, M.; Singh, A.; Starosciak, A.; Strasser, S.; Szeder, V.; Teleb, M.; Tsai, J.; Mohammaden, M.; Pineda-Franks, C.; Asyraf, W.; Nguyen, T. Q.; Tarkanyi, A.; Haussen, D.; Balaguera, O.; Rodriguezvasquez, A.; Nogueira, R..

Neurology ; 96(15 SUPPL 1), 2021.

Article in English | EMBASE | ID: covidwho-1407898

ABSTRACT

Objective: The objectives of this study were to measure the global impact of the pandemic on the volumes for intravenous thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with two control 4-month periods. Background: The COVID-19 pandemic led to widespread repercussions on the delivery of health care worldwide. Design/Methods: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by ICD-10 codes and/or classifications in stroke center databases. Results: There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95%CI,-11.7 to-11.3, p<0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95%CI,-13.8 to-12.7, p<0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95%CI,-13.7 to-10.3, p=0.001). There were greater declines in primary compared to comprehensive stroke centers (CSC) for stroke hospitalizations (-17.3% vs-10.3%, p<0.0001) and IVT (-15.5% vs-12.6%, p=0.0001). Recovery of stroke hospitalization volume (9.5%, 95%CI 9.2-9.8, p<0.0001) was noted over the two later (May, June) versus the two earlier (March, April) months of the pandemic, with greater recovery in hospitals with lower COVID-19 hospitalization volume, high volume stroke center, and CSC. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. SARS-CoV-2 infection was noted in 3.3% (1,722/52,026) of all stroke admissions. Conclusions: The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months, with greater recovery in hospitals with lower COVID-19 hospitalizations, high volume stroke centers, and CSCs.

5.

Cerebrovascular events and outcomes in hospitalized patients with COVID-19: the society of vascular and interventional neurology multinational registry

Siegler, J. E.; Portela, P.; Arenillas, J. F.; Chavarria-Miranda, A.; Guillen, A.; De Lera, M.; Khandelwal, P.; Bach, I.; Patel, P.; Singla, A.; Requena, M.; Ribo, M.; Jillella, D. V.; Nogueira, R. G.; Haussen, D. C.; Vazquez, A. R.; Urra, X.; Roman, L. S.; Thon, J. M.; Then, R.; De la Ossa, N. P.; Millan, M.; Mansour, O.; Tiu, C.; Nguyen, T.; Kaliaev, A.; Czap, A. L.; Zha, A.; Liebeskind, D. S.; Ortega-Gutierrez, S.; Farooqui, M.; Hassan, A. E.; Bushnaq, S.; Zaidat, O. O.; Jovin, T. G..

Stroke ; 52(SUPPL 1), 2021.

Article in English | EMBASE | ID: covidwho-1234341

ABSTRACT

Background: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has been associated with a significant risk of thrombotic events in critically ill patients. Aims: To summarize the findings of a multinational observational cohort of patients with SARS-CoV- 2 and cerebrovascular disease. Methods: Retrospective observational cohort of consecutive adults evaluated in the emergency department and/or admitted with coronavirus disease 2019 (COVID-19) across 31 hospitals in 4 countries (2/1/2020 - 06/16/2020). The primary outcome was the incidence rate of cerebrovascular events, inclusive of acute ischemic stroke, intracranial hemorrhages (ICH), and cortical vein and/or sinus thrombosis (CVST). Results: Of the 14,483 patients with laboratory-confirmed SARS-CoV-2, 172 were diagnosed with an acute cerebrovascular event (1.13% of cohort;1130/100,000 patients, 95%CI 970- 1320/100,000), 68/171 (40.5%) of whom were female and 96/172 (55.8%) were between the ages 60-79 years. Of these, 156 had acute ischemic stroke (1.08%;1080/100,000 95%CI 920- 1260/100,000), 28 ICH (0.19%;190/100,000 95%CI 130 - 280/100,000) and 3 with CVST (0.02%;20/100,000, 95%CI 4-60/100,000). The in-hospital mortality rate for SARS-CoV-2-associated stroke was 38.1% and for ICH 58.3%. After adjusting for clustering by site and age, baseline strokeseverity, and all predictors of in-hospital mortality found in univariate regression (p<0.1: male sex,tobacco use, arrival by emergency medical services, lower platelet and lymphocyte counts, andintracranial occlusion), cryptogenic stroke mechanism (aOR 5.01, 95%CI 1.63-15.44, p<0.01), olderage (aOR 1.78, 95%CI 1.07-2.94, p=0.03), and lower lymphocyte count on admission (aOR 0.58,95%CI 0.34-0.98 p=0.04) were the only independent predictors of mortality among patients withstroke and COVID-19. Conclusions: COVID-19 is associated with a small but significant risk of clinically relevantcerebrovascular events, particularly ischemic stroke. The mortality rate is high for COVID-19associated cerebrovascular complications, therefore aggressive monitoring and early interventionshould be pursued to mitigate poor outcomes.

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