Indicators of high morbidity and poor functional outcome in acute ischemic stroke patients with concurrent covid-19
Stroke
; 53(SUPPL 1), 2022.
Article
in English
| EMBASE | ID: covidwho-1724015
ABSTRACT
Objectives:
Evidence suggests an association of increased cerebrovascular accidents frequency in patients diagnosed with the novel coronavirus disease, COVID-19. Coagulopathy resulting from the 2019 novel coronavirus (SARS-CoV-2) infection is suspected. This study aims at evaluating thrombotic markers in relation to stroke severity and functional outcomes in a patient cohort of acute ischemic stroke (AIS) with concurrent COVID-19.Methods:
We performed a retrospective observational cohort study of 28 patients who tested positive for SARS-CoV-2 via polymerase chain reaction and concomitant AIS confirmed by brain imaging. We analyzed data regarding initial stroke presentation, markers of coagulopathy, and 90- day functional outcomes.Results:
The patient cohort displayed high rate of comorbidities with 78.6% having at least 1 vascular risk factor. NIHSS had a median of 16 at initial presentation and median stroke volume of 52 mL. Median NIHSS at discharge or prior to death was 19, and median 90-day mRS was 4. Highest fibrinogen level recorded showed a median of 759.54 mg/dL (IQR 653.75-940.75), D-dimer and lactate dehydrogenase (LDH) showed a median highest recorded value 24,106 ng/mL (IQR 6105.00-80165.00) and 442 ng/mL (IQR 277.00-545.50), respectively. LDH (p=0.0008), D-dimer (p=0.001), and maximum fibrinogen levels (p=0.049) near the time of stroke significantly predicted final NIHSS and functional outcome 90-days after discharge.Conclusions:
Adult patients with acute ischemic stroke and concurrent COVID-19 disease exhibited abnormally high markers of coagulopathy, and LDH, D-Dimer, and fibrinogen levels were predictors of morbidity and neurological disability at 90-days in this patient population. Further research is necessary to establish a definitive pattern and assess the ability to use these markers as prognostic elements of 90-day functional outcome.
D dimer; endogenous compound; fibrinogen; lactate dehydrogenase; acute ischemic stroke; adult; blood clotting disorder; cardiovascular risk; case report; cerebrovascular accident; clinical article; cohort analysis; comorbidity; conference abstract; coronavirus disease 2019; female; gene amplification; gene expression; heart stroke volume; human; male; morbidity; National Institutes of Health Stroke Scale; neurodisability; neuroimaging; nonhuman; outcome assessment; polymerase chain reaction; Rankin scale; retrospective study; Severe acute respiratory syndrome coronavirus 2; stroke patient; thrombosis
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Prognostic study
Language:
English
Journal:
Stroke
Year:
2022
Document Type:
Article
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