SAFETY AND OUTCOME OF REVASCULARIZATION TREATMENTS IN PATIENTS WITH ACUTE ISCHEMIC STROKE AND COVID-19: RESULTS OF THE GLOBAL COVID-19 STROKE REGISTRY
European Stroke Journal
; 7(1 SUPPL):102, 2022.
Article
in English
| EMBASE | ID: covidwho-1928106
ABSTRACT
Background and aims:
COVID-19 related inflammation, endothelial dysfunction and coagulopathy may increase the bleeding risk and lower the efficacy of revascularization treatments in patients with ischemic stroke (IS). We aimed to evaluate the safety and disability outcomes of revascularization treatments in patients with IS and COVID-19.Methods:
Retrospective multicenter cohort study of consecutive IS patients receiving intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) between March-2020 and June-2021, tested for SARSCoV- 2 infection. With a doubly-robust model combining propensity score weighting and multivariate regression, we studied the association of COVID-19 with bleeding complications and clinical outcomes. Subgroup analyses were performed according to treatment groups (IVT-only and EVT). Study protocol was registered in ClinicalTrials.gov (NCT04895462).Results:
Among 15128 revascularized patients from 105 centers, 853 (5.6%) were diagnosed with COVID-19. 5848 (38.7%) patients received IVT only, and 9280 (61.3%) EVT (+/- IVT). As shown in the Figure, treated patients with COVID-19 had a higher rate of symptomatic intracerebral hemorrhage (SICH), symptomatic subarachnoid hemorrhage (sSAH), the combination thereof, higher mortality at 24 hours and 3 months, and worse 3-month modified Rankin score (mRS). Results for treatment subgroups were similar, except that in the IVT-only group only SICH, 3-month mRS and mortality were significantly increased.Conclusion:
Ischemic stroke patients with COVID-19 showed higher rates of bleeding complications and worse clinical outcomes after acute revascularization treatments than contemporaneous non-COVID-19 treated patients. (Table Presented).
acute ischemic stroke; adult; blood clot lysis; brain hemorrhage; cerebrovascular accident; clinical outcome; cohort analysis; complication; conference abstract; controlled study; coronavirus disease 2019; disability; drug safety; female; human; major clinical study; male; mortality; multicenter study; outcome assessment; propensity score; Rankin scale; retrospective study; revascularization; stroke patient; subarachnoid hemorrhage
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Prognostic study
Language:
English
Journal:
European Stroke Journal
Year:
2022
Document Type:
Article
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