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Stroke etiologies in patients with COVID-19: the SVIN COVID-19 multinational registry.
Ramos-Araque, María E; Siegler, James E; Ribo, Marc; Requena, Manuel; López, Cristina; de Lera, Mercedes; Arenillas, Juan F; Pérez, Isabel Hernández; Gómez-Vicente, Beatriz; Talavera, Blanca; Portela, Pere Cardona; Guillen, Ana Nuñez; Urra, Xabier; Llull, Laura; Renú, Arturo; Nguyen, Thanh N; Jillella, Dinesh; Nahab, Fadi; Nogueira, Raul; Haussen, Diogo; Then, Ryna; Thon, Jesse M; Esparragoza, Luis Rodríguez; Hernández-Pérez, Maria; Bustamante, Alejandro; Mansour, Ossama Yassin; Megahed, Mohammed; Hassan, Tamer; Liebeskind, David S; Hassan, Ameer; Bushnaq, Saif; Osman, Mohamed; Vazquez, Alejandro Rodriguez.
  • Ramos-Araque ME; Institute of Biomedical Research of Salamanca, Department of Neurology, Hospital Universitario de Salamanca, Salamanca, Spain.
  • Siegler JE; Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
  • Ribo M; Cooper Neurologic Institute, Cooper University Hospital, Camden, NJ, USA. siegler-james@cooperhealth.edu.
  • Requena M; Stroke Unit, Department of Neurology, Vall d'Hebron Research Institute, Barcelona, Spain.
  • López C; Departament of Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain.
  • de Lera M; Stroke Unit, Department of Neurology, Vall d'Hebron Research Institute, Barcelona, Spain.
  • Arenillas JF; Departament of Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain.
  • Pérez IH; Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
  • Gómez-Vicente B; Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
  • Talavera B; Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
  • Portela PC; Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
  • Guillen AN; Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
  • Urra X; Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
  • Llull L; Department of Neurology, Hospital Universitari, Bellvitge, Barcelona, Spain.
  • Renú A; Department of Neurology, Hospital Universitari, Bellvitge, Barcelona, Spain.
  • Nguyen TN; Department of Neurology, Hospital Clínic, Barcelona, Spain.
  • Jillella D; Department of Neurology, Hospital Clínic, Barcelona, Spain.
  • Nahab F; Department of Neurology, Hospital Clínic, Barcelona, Spain.
  • Nogueira R; Department of Neurology, Department of Radiology, Department of Neurosurgery, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
  • Haussen D; Department of Neurology, Emory University School of Medicine, Atlanta, USA.
  • Then R; Department of Neurology, Emory University School of Medicine, Atlanta, USA.
  • Thon JM; Department of Neurology, Grady Memorial Hospital, Atlanta, GA, USA.
  • Esparragoza LR; Department of Neurology, Grady Memorial Hospital, Atlanta, GA, USA.
  • Hernández-Pérez M; Cooper Neurologic Institute, Cooper University Hospital, Camden, NJ, USA.
  • Bustamante A; Cooper Neurologic Institute, Cooper University Hospital, Camden, NJ, USA.
  • Mansour OY; Stroke Unit, Neuroscience Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
  • Megahed M; Stroke Unit, Neuroscience Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
  • Hassan T; Stroke Unit, Neuroscience Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
  • Liebeskind DS; Neurology Department, Stroke and neurointervention unit, Alexandria University, Alexandria, Egypt.
  • Hassan A; Critical care Department, Alexandria University, Alexandria, Egypt.
  • Bushnaq S; Neurosurgery Department, Stroke and Neurointervention unit, Alexandria University, Alexandria, Egypt.
  • Osman M; Department of Neurology, Ronald Reagan UCLA Medical Center, Los Angeles, USA.
  • Vazquez AR; Department of Clinical Neuroscience Research, Valley Baptist Medical Center, Harlingen, TX, USA.
BMC Neurol ; 21(1): 43, 2021 Jan 30.
Article in English | MEDLINE | ID: covidwho-1054807
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
2. COVID-19 PREDISPOSES Cerebrovascular accident
Subject
COVID-19
Predicate
PREDISPOSES
Object
Cerebrovascular accident
3. Cerebrovascular accident PROCESS_OF Patients
Subject
Cerebrovascular accident
Predicate
PROCESS_OF
Object
Patients
4. Cryptogenic Ischemic Stroke PROCESS_OF Patients
Subject
Cryptogenic Ischemic Stroke
Predicate
PROCESS_OF
Object
Patients
5. Acute Ischemic Stroke PROCESS_OF Patients
Subject
Acute Ischemic Stroke
Predicate
PROCESS_OF
Object
Patients
6. C-reactive protein ASSOCIATED_WITH Acute Ischemic Stroke
Subject
C-reactive protein
Predicate
ASSOCIATED_WITH
Object
Acute Ischemic Stroke
7. Fibrin fragment D ASSOCIATED_WITH Acute Ischemic Stroke
Subject
Fibrin fragment D
Predicate
ASSOCIATED_WITH
Object
Acute Ischemic Stroke
8. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
9. COVID-19 PREDISPOSES Cerebrovascular accident
Subject
COVID-19
Predicate
PREDISPOSES
Object
Cerebrovascular accident
10. Cerebrovascular accident PROCESS_OF Patients
Subject
Cerebrovascular accident
Predicate
PROCESS_OF
Object
Patients
11. Cryptogenic Ischemic Stroke PROCESS_OF Patients
Subject
Cryptogenic Ischemic Stroke
Predicate
PROCESS_OF
Object
Patients
12. Acute Ischemic Stroke PROCESS_OF Patients
Subject
Acute Ischemic Stroke
Predicate
PROCESS_OF
Object
Patients
13. C-reactive protein ASSOCIATED_WITH Acute Ischemic Stroke
Subject
C-reactive protein
Predicate
ASSOCIATED_WITH
Object
Acute Ischemic Stroke
14. Fibrin fragment D ASSOCIATED_WITH Acute Ischemic Stroke
Subject
Fibrin fragment D
Predicate
ASSOCIATED_WITH
Object
Acute Ischemic Stroke
ABSTRACT
BACKGROUND AND

PURPOSE:

Coronavirus disease 2019 (COVID-19) is associated with a small but clinically significant risk of stroke, the cause of which is frequently cryptogenic. In a large multinational cohort of consecutive COVID-19 patients with stroke, we evaluated clinical predictors of cryptogenic stroke, short-term functional outcomes and in-hospital mortality among patients according to stroke etiology.

METHODS:

We explored clinical characteristics and short-term outcomes of consecutively evaluated patients 18 years of age or older with acute ischemic stroke (AIS) and laboratory-confirmed COVID-19 from 31 hospitals in 4 countries (3/1/20-6/16/20).

RESULTS:

Of the 14.483 laboratory-confirmed patients with COVID-19, 156 (1.1%) were diagnosed with AIS. Sixty-one (39.4%) were female, 84 (67.2%) white, and 88 (61.5%) were between 60 and 79 years of age. The most frequently reported etiology of AIS was cryptogenic (55/129, 42.6%), which was associated with significantly higher white blood cell count, c-reactive protein, and D-dimer levels than non-cryptogenic AIS patients (pin-hospital mortality, cryptogenic stroke mechanism was associated with a fivefold greater odds in-hospital mortality than strokes due to any other mechanism (adjusted OR 5.16, 95%CI 1.41-18.87, p = 0.01). In that model, older age (aOR 2.05 per decade, 95%CI 1.35-3.11, p < 0.01) and higher baseline NIHSS (aOR 1.12, 95%CI 1.02-1.21, p = 0.01) were also independently predictive of mortality.

CONCLUSIONS:

Our findings suggest that cryptogenic stroke among COVID-19 patients carries a significant risk of early mortality.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Registries / Hospital Mortality / Ischemic Stroke / COVID-19 Type of study: Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Africa / North America / Europa Language: English Journal: BMC Neurol Journal subject: Neurology Year: 2021 Document Type: Article Affiliation country: S12883-021-02075-1

Full text: Available Collection: International databases Database: MEDLINE Main subject: Registries / Hospital Mortality / Ischemic Stroke / COVID-19 Type of study: Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Africa / North America / Europa Language: English Journal: BMC Neurol Journal subject: Neurology Year: 2021 Document Type: Article Affiliation country: S12883-021-02075-1