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Characteristics of a COVID-19 Cohort With Large Vessel Occlusion: A Multicenter International Study.
Jabbour, Pascal; Dmytriw, Adam A; Sweid, Ahmad; Piotin, Michel; Bekelis, Kimon; Sourour, Nader; Raz, Eytan; Linfante, Italo; Dabus, Guilherme; Kole, Max; Martínez-Galdámez, Mario; Nimjee, Shahid M; Lopes, Demetrius K; Hassan, Ameer E; Kan, Peter; Ghorbani, Mohammad; Levitt, Michael R; Escalard, Simon; Missios, Symeon; Shapiro, Maksim; Clarençon, Frédéric; Elhorany, Mahmoud; Vela-Duarte, Daniel; Tahir, Rizwan A; Youssef, Patrick P; Pandey, Aditya S; Starke, Robert M; El Naamani, Kareem; Abbas, Rawad; Hammoud, Bassel; Mansour, Ossama Y; Galvan, Jorge; Billingsley, Joshua T; Mortazavi, Abolghasem; Walker, Melanie; Dibas, Mahmoud; Settecase, Fabio; Heran, Manraj K S; Kuhn, Anna L; Puri, Ajit S; Menon, Bijoy K; Sivakumar, Sanjeev; Mowla, Ashkan; D'Amato, Salvatore; Zha, Alicia M; Cooke, Daniel; Goyal, Mayank; Wu, Hannah; Cohen, Jake; Turkel-Parrella, David.
  • Jabbour P; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
  • Dmytriw AA; Interventional Neuroradiology & Endovascular Neurosurgery Service, Mass General Brigham Partners, Harvard Medical School, Boston, Massachusetts, USA.
  • Sweid A; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
  • Piotin M; Department of Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France.
  • Bekelis K; Department of Neurosurgery, Good Samaritan Hospital Medical Center, West Islip, New York, USA.
  • Sourour N; Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.
  • Raz E; Department of Radiology, New York University Langone Medical Center, New York, New York, USA.
  • Linfante I; Department of Interventional Neuroradiology & Neuroendovascular Surgery, Miami Cardiac and Vascular Institute, Baptist Hospital of Miami, Miami, Florida, USA.
  • Dabus G; Department of Interventional Neuroradiology & Neuroendovascular Surgery, Miami Cardiac and Vascular Institute, Baptist Hospital of Miami, Miami, Florida, USA.
  • Kole M; Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan, USA.
  • Martínez-Galdámez M; Department of Interventional Neuroradiology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
  • Nimjee SM; Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
  • Lopes DK; Department of Neurosurgery, Advocate Aurora Health, Chicago, Illinois, USA.
  • Hassan AE; Department of Neuroscience, Valley Baptist Medical Center/University of Texas Rio Grande Valley, Harlingen, Texas, USA.
  • Kan P; Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.
  • Ghorbani M; Department of Neurosurgery, University of Texas Medical Branch, Galveston, Texas, USA.
  • Levitt MR; Department of Neurosurgery, Firoozgar Hospital, Tehran, Iran.
  • Escalard S; Departments of Neurological Surgery, Radiology, Mechanical Engineering, and Stroke & Applied Neuroscience Center, University of Washington, Seattle, Washington, USA.
  • Missios S; Department of Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France.
  • Shapiro M; Department of Neurosurgery, Good Samaritan Hospital Medical Center, West Islip, New York, USA.
  • Clarençon F; Department of Radiology, New York University Langone Medical Center, New York, New York, USA.
  • Elhorany M; Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.
  • Vela-Duarte D; Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.
  • Tahir RA; Department of Interventional Neuroradiology & Neuroendovascular Surgery, Miami Cardiac and Vascular Institute, Baptist Hospital of Miami, Miami, Florida, USA.
  • Youssef PP; Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan, USA.
  • Pandey AS; Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
  • Starke RM; Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
  • El Naamani K; Department of Neurosurgery & Neuroradiology, University of Miami & Jackson Memorial Hospital, Miami, Florida, USA.
  • Abbas R; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
  • Hammoud B; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
  • Mansour OY; Department of Biomedical Engineering, American University of Beirut, Beirut, Lebanon.
  • Galvan J; Department of Neurology and Neuroradiology, Alexandria University Hospital, Al Attarin, Egypt.
  • Billingsley JT; Department of Interventional Neuroradiology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
  • Mortazavi A; Department of Neurosurgery, Advocate Aurora Health, Chicago, Illinois, USA.
  • Walker M; Department of Neuroscience, Valley Baptist Medical Center/University of Texas Rio Grande Valley, Harlingen, Texas, USA.
  • Dibas M; Departments of Neurological Surgery and Stroke & Applied Neuroscience Center, University of Washington, Seattle, Washington, USA.
  • Settecase F; Interventional Neuroradiology & Endovascular Neurosurgery Service, Mass General Brigham Partners, Harvard Medical School, Boston, Massachusetts, USA.
  • Heran MKS; Division of Neuroradiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, USA.
  • Kuhn AL; Division of Neuroradiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, USA.
  • Puri AS; Division of Neurointerventional Radiology, Department of Radiology, UMass Memorial Medical Center, Worcester, Massachusetts, USA.
  • Menon BK; Division of Neurointerventional Radiology, Department of Radiology, UMass Memorial Medical Center, Worcester, Massachusetts, USA.
  • Sivakumar S; Calgary Stroke Program, Cumming School of Medicine, Calgary, Alberta, Canada.
  • Mowla A; Department of Neurosurgery & Neuroradiology, University of Miami & Jackson Memorial Hospital, Miami, Florida, USA.
  • D'Amato S; Department of Neurological Surgery, University of Southern California, Los Angeles, California, USA.
  • Zha AM; Interventional Neuroradiology & Endovascular Neurosurgery Service, Mass General Brigham Partners, Harvard Medical School, Boston, Massachusetts, USA.
  • Cooke D; Department of Neurology, UT Health Science Center, Houston, Texas, USA.
  • Goyal M; Department of Neurointerventional Radiology, San Francisco General Hospital, San Francisco, California, USA.
  • Wu H; Calgary Stroke Program, Cumming School of Medicine, Calgary, Alberta, Canada.
  • Cohen J; Department of Neurology, Brookdale University Hospital, Brooklyn, New York, USA.
  • Turkel-Parrella D; Department of Neurology, Jamaica Medical Center, Richmond Hill, New York, USA.
Neurosurgery ; 90(6): 725-733, 2022 06 01.
Article in English | MEDLINE | ID: covidwho-1724730
ABSTRACT

BACKGROUND:

The mechanisms and outcomes in coronavirus disease (COVID-19)-associated stroke are unique from those of non-COVID-19 stroke.

OBJECTIVE:

To describe the efficacy and outcomes of acute revascularization of large vessel occlusion (LVO) in the setting of COVID-19 in an international cohort.

METHODS:

We conducted an international multicenter retrospective study of consecutively admitted patients with COVID-19 with concomitant acute LVO across 50 comprehensive stroke centers. Our control group constituted historical controls of patients presenting with LVO and receiving a mechanical thrombectomy between January 2018 and December 2020.

RESULTS:

The total cohort was 575 patients with acute LVO; 194 patients had COVID-19 while 381 patients did not. Patients in the COVID-19 group were younger (62.5 vs 71.2; P < .001) and lacked vascular risk factors (49, 25.3% vs 54, 14.2%; P = .001). Modified thrombolysis in cerebral infarction 3 revascularization was less common in the COVID-19 group (74, 39.2% vs 252, 67.2%; P < .001). Poor functional outcome at discharge (defined as modified Ranklin Scale 3-6) was more common in the COVID-19 group (150, 79.8% vs 132, 66.7%; P = .004). COVID-19 was independently associated with a lower likelihood of achieving modified thrombolysis in cerebral infarction 3 (odds ratio [OR] 0.4, 95% CI 0.2-0.7; P < .001) and unfavorable outcomes (OR 2.5, 95% CI 1.4-4.5; P = .002).

CONCLUSION:

COVID-19 was an independent predictor of incomplete revascularization and poor outcomes in patients with stroke due to LVO. Patients with COVID-19 with LVO were younger, had fewer cerebrovascular risk factors, and suffered from higher morbidity/mortality rates.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Brain Ischemia / Stroke / COVID-19 Type of study: Controlled clinical trial / Etiology study / Observational study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Neurosurgery Year: 2022 Document Type: Article Affiliation country: NEU.0000000000001902

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Brain Ischemia / Stroke / COVID-19 Type of study: Controlled clinical trial / Etiology study / Observational study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Neurosurgery Year: 2022 Document Type: Article Affiliation country: NEU.0000000000001902