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Age and Acute Ischemic Stroke Outcome in North American Patients With COVID-19.
Dmytriw, Adam A; Dibas, Mahmoud; Schirmer, Clemens M; Settecase, Fabio; Heran, Manraj K S; Efendizade, Aslan; Kühn, Anna Luisa; Puri, Ajit S; Ospel, Johanna; Menon, Bijoy; Sivakumar, Sanjeev; Mowla, Ashkan; Vela-Duarte, Daniel; Linfante, Italo; Dabus, Guilherme; Regenhardt, Robert W; Patel, Aman B; Leslie-Mazwi, Thabele; D'Amato, Salvatore; Rosenthal, Joseph; Zha, Alicia; Talukder, Nafee; Sheth, Sunil; Cooke, Daniel; Leung, Lester Y; Malek, Adel; Voetsch, Barbara; Sehgal, Siddharth; Wakhloo, Ajay K; Wu, Hannah; Cohen, Jake; Turkel-Parella, David; Xavier, Andrew; Tiwari, Ambooj.
  • Dmytriw AA; Neuroradiology & Neurology Services Brigham and Women's Hospital Harvard Medical School Boston MA.
  • Dibas M; Neuroradiology & Neurology Services Brigham and Women's Hospital Harvard Medical School Boston MA.
  • Schirmer CM; Department of Neurosurgery & Neuroscience Institute Geisinger Health Wilkes-Barre PA.
  • Settecase F; Division of Neuroradiology Vancouver General HospitalUniversity of British Columbia Vancouver BC.
  • Heran MKS; Division of Neuroradiology Vancouver General HospitalUniversity of British Columbia Vancouver BC.
  • Efendizade A; Department of Radiology SUNY Downstate School of Medicine Brooklyn NY.
  • Kühn AL; Division of Neurointerventional Radiology Department of Radiology UMass Memorial Medical Center Worcester MA.
  • Puri AS; Division of Neurointerventional Radiology Department of Radiology UMass Memorial Medical Center Worcester MA.
  • Ospel J; Calgary Stroke Program Cumming School of Medicine Calgary Alberta Canada.
  • Menon B; Calgary Stroke Program Cumming School of Medicine Calgary Alberta Canada.
  • Sivakumar S; Department of Medicine (Neurology) Prisma Health UpstateUSC Greenville SC.
  • Mowla A; Department of Neurological Surgery University of Southern California Los Angeles CA.
  • Vela-Duarte D; Neuroradiology & Neurology Services Miami Baptist Medical Center Miami FL.
  • Linfante I; Neuroradiology & Neurology Services Miami Baptist Medical Center Miami FL.
  • Dabus G; Neuroradiology & Neurology Services Miami Baptist Medical Center Miami FL.
  • Regenhardt RW; Neurology & Neurosurgery Services Massachusetts General HospitalHarvard Medical School Boston MA.
  • Patel AB; Neurology & Neurosurgery Services Massachusetts General HospitalHarvard Medical School Boston MA.
  • Leslie-Mazwi T; Neurology & Neurosurgery Services Massachusetts General HospitalHarvard Medical School Boston MA.
  • D'Amato S; Neuroradiology & Neurology Services Brigham and Women's Hospital Harvard Medical School Boston MA.
  • Rosenthal J; Neuroradiology & Neurology Services Brigham and Women's Hospital Harvard Medical School Boston MA.
  • Zha A; Department of Neurology UT Health Science Center Houston TX.
  • Talukder N; Department of Neurology UT Health Science Center Houston TX.
  • Sheth S; Department of Neurology UT Health Science Center Houston TX.
  • Cooke D; Department of Neurointerventional Radiology San Francisco General Hospital San Francisco CA.
  • Leung LY; Departments of Neurology and Neurosurgery Tufts Medical Center Boston MA.
  • Malek A; Departments of Neurology and Neurosurgery Tufts Medical Center Boston MA.
  • Voetsch B; Department of Neurology & Neurointerventional Radiology Lahey Hospital & Medical Center Burlington MA.
  • Sehgal S; Department of Neurology & Neurointerventional Radiology Lahey Hospital & Medical Center Burlington MA.
  • Wakhloo AK; Department of Neurology & Neurointerventional Radiology Lahey Hospital & Medical Center Burlington MA.
  • Wu H; Department of Neurology Brookdale University Hospital Brooklyn NY.
  • Cohen J; Department of Neurology Jamaica Medical Center Richmond Hill NY.
  • Turkel-Parella D; Department of Neurology NYU Lutheran Hospital Brooklyn NY.
  • Xavier A; Department of Neurology Brookdale University Hospital Brooklyn NY.
  • Tiwari A; Department of Neurology Jamaica Medical Center Richmond Hill NY.
J Am Heart Assoc ; 10(14): e021046, 2021 07 20.
Article in English | MEDLINE | ID: covidwho-1463078
ABSTRACT
Background Acute ischemic stroke (AIS) in the context of COVID-19 has received considerable attention for its propensity to affect patients of all ages. We aimed to evaluate the effect of age on functional outcome and mortality following an acute ischemic event. Methods and Results A prospectively maintained database from comprehensive stroke centers in Canada and the United States was analyzed for patients with AIS from March 14 to September 30, 2020 who tested positive for SARS-CoV-2. The primary outcome was Modified Rankin Scale score at discharge, and the secondary outcome was mortality. Baseline characteristics, laboratory values, imaging, and thrombectomy workflow process times were assessed. Among all 126 patients with COVID-19 who were diagnosed with AIS, the median age was 63 years (range, 27-94). There were 35 (27.8%) patients with AIS in the aged ≤55 years group, 47 (37.3%) in the aged 56 to 70 group, and 44 (34.9%) in the aged >70 group. Intravenous tissue plasminogen activator and thrombectomy rates were comparable across these groups, (P=0.331 and 0.212, respectively). There was a significantly lower rate of mortality between each group favoring younger age (21.9% versus 45.0% versus 48.8%, P=0.047). After multivariable adjustment for possible confounders, a 1-year increase in age was significantly associated with fewer instances of a favorable outcome of Modified Rankin Scale 0 to 2 (odds ratio [OR], 0.95; 95 CI%, 0.90-0.99; P=0.048) and higher mortality (OR, 1.06; 95 CI%, 1.02-1.10; P=0.007). Conclusions AIS in the context of COVID-19 affects young patients at much greater rates than pre-pandemic controls. Nevertheless, instances of poor functional outcome and mortality are closely tied to increasing age.
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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Ischemic Stroke / COVID-19 Subject: Ischemic Stroke / COVID-19 Type of study: Observational study / Risk factors Language: English Journal: J Am Heart Assoc Clinical aspect: Etiology Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Ischemic Stroke / COVID-19 Subject: Ischemic Stroke / COVID-19 Type of study: Observational study / Risk factors Language: English Journal: J Am Heart Assoc Clinical aspect: Etiology Year: 2021
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