Neurovascular and infectious disease phenotype of acute stroke patients with and without COVID-19.
Neurol Sci
; 43(8): 4619-4625, 2022 Aug.
Article
in English
| MEDLINE | ID: covidwho-1859005
ABSTRACT
BACKGROUND:
The infectious disease phenotype of acute stroke associated with COVID-19 has been poorly characterized.OBJECTIVE:
We investigated the neurovascular and infectious disease phenotype of stroke patients with and without COVID-19 infection, and their effect on in-hospital mortality.METHODS:
This is a retrospective cohort study of consecutive patients with acute stroke, admitted to any ward of a hub hospital for stroke in Lombardy, Italy, during the first wave of COVID-19. Demographic, neurovascular, infectious disease, and respiratory characteristics were collected. The effect of clinical variables on survival was evaluated using logistic regression models.RESULTS:
One hundred thirty-seven patients with acute stroke were recruited; 30 (21.9%) patients had COVID-19 and represented 2.5% of the 1218 COVID-19 patients hospitalized in the study period. Demographics, comorbidities, stroke type, stroke severity, and etiology did not differ between COVID + stroke patients and non-COVID stroke patients, except for an excess of multi-embolic ischemic stroke in the COVID + group. Most COVID + stroke patients had symptomatic infection (60%) and interstitial pneumonia (70%). COVID + stroke patients required more frequently respiratory support (77% versus 29%; p < 0.0001) and had higher in-hospital mortality (40% versus 12%; p = 0.0005) than non-COVID stroke patients. Mortality was independently associated with symptomatic interstitial pneumonia (aOR 6.7; 95% CI 2.0-22.5; p = 0.002) and, to a lesser extent, with NIHSS on admission (aOR 1.1; 95% CI 1.03-1.2; p = 0.007) and recanalization therapies (aOR 0.2; 95% CI 0.04-0.98; p = 0.046).CONCLUSION:
Symptomatic interstitial pneumonia was the major driver of in-hospital mortality in COVID + stroke patients.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Communicable Diseases
/
Lung Diseases, Interstitial
/
Stroke
/
COVID-19
Type of study:
Cohort study
/
Etiology study
/
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Humans
Language:
English
Journal:
Neurol Sci
Journal subject:
Neurology
Year:
2022
Document Type:
Article
Affiliation country:
S10072-022-06133-5
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