ABSTRACT
2020 was the year of the pandemic that shut down the world, killed more than 1.5 million people and infected many more. But it was also the year science suddenly occupied centre stage and scientists became "essential workers”. SARS-CoV-2 was a threat to humanity but also a puzzle to be solved and scientists had the expertise, the tools and the money to do so. That put science under public scrutiny, and, suddenly, people saw that science in action was quite different from what school textbooks, science documentaries and films had shown us. We were witnessing something that lay people were not supposed to see: science in (fast) action with its controversies and negotiations, with its mistakes and retractions, with the contradictions of science as a search for truth and the search for profit of academic capitalism, etc. We were disappointed. In this chapter, I will maintain that this unexpected "public life” of science became an important source of uncertainty and discontent, fuelling the emergence of conspiracy theories, and this was due to our traditional understanding of science. I will conclude that we need a more realistic public image of science which exposes its achievements as well as its controversies, contradictions, pitfalls and mistakes. © 2023 selection and editorial matter, Carlos de Castro, Andrés Pedreño and Marta Latorre;individual chapters, the contributors.
ABSTRACT
Background and Aims: We evaluated whether stroke severity, functional outcome and mortality are different in patients with ischemic stroke with or without 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 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, NIHSS 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 multivariate 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 NIHSS score was higher in COVID-19 patients compared to patients without COVID-19 [8 (3-18) vs 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 multivariate logistic regression analysis, COVID-19 infection did not increase the probability of unfavourable functional outcome. Mortality rate was 39.3% among COVID-19 patients and 16.1% in the non-COVID-19 group. In the multivariate logistic regression analysis, COVID-19 infection was a risk factor for mortality (HR 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 higher mortality than stroke patients without COVID-19 infection. However, functional outcome is comparable in both groups.