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COVID-19 and Stroke Recurrence by Subtypes: A Propensity-Score Matched Analyses of Stroke Subtypes in 44,994 Patients.
Nia, Anna M; Srinivasan, Visish M; Lall, Rishi R; Kan, Peter.
  • Nia AM; Department of Neurosurgery, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, USA. Electronic address: amnia@utmb.edu.
  • Srinivasan VM; Department of Neurosurgery, Barrow Neurological Institute, 350 W Thomas Rd, Phoenix, AZ 85013, USA.
  • Lall RR; Department of Neurosurgery, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, USA.
  • Kan P; Department of Neurosurgery, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, USA.
J Stroke Cerebrovasc Dis ; 31(8): 106591, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1931013
ABSTRACT

BACKGROUND:

Cerebrovascular diseases (CVDs), including varying strokes, can recur in patients upon coronavirus disease 2019 (COVID-19) diagnosis, but risk factor stratification based on stroke subtypes and outcomes is not well studied in large studies using propensity-score matching. We identified risk factors and stroke recurrence based on varying subtypes in patients with a prior CVD and COVID-19.

METHODS:

We analyzed data from 45 health care organizations and created cohorts based on ICDs for varying stroke subtypes utilizing the TriNetX Analytics Network. We measured the odds ratios and risk differences of hospitalization, ICU/critical care services, intubation, mortality, and stroke recurrence in patients with COVID-19 compared to propensity-score matched cohorts without COVID-19 within 90-days.

RESULTS:

22,497 patients with a prior history of CVD within 10 years and COVID-19 diagnosis were identified. All cohorts with a previous CVD diagnosis had an increased risk of hospitalization, ICU, and mortality. Additionally, the data demonstrated that a history of ischemic stroke increased the risk for hemorrhagic stroke and transient ischemic attack (TIA) (OR1.59, 1.75, p-value 0.044*, 0.043*), but a history of hemorrhagic stroke was associated with a higher risk for hemorrhagic strokes only (ORs 3.2, 1.7, 1.7 and p-value 0.001*, 0.028*, 0.001*). History of TIA was not associated with increased risk for subsequent strokes upon COVID-19 infection (all p-values ≥ 0.05).

CONCLUSIONS:

COVID-19 was associated with an increased risk for hemorrhagic strokes and TIA among all ischemic stroke patients, an increased risk for hemorrhagic stroke in hemorrhagic stroke patients, and no associated increased risk for any subsequent strokes in TIA patients.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Ischemic Attack, Transient / Stroke / Ischemic Stroke / Hemorrhagic Stroke / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: J Stroke Cerebrovasc Dis Journal subject: Vascular Diseases / Brain Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Ischemic Attack, Transient / Stroke / Ischemic Stroke / Hemorrhagic Stroke / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: J Stroke Cerebrovasc Dis Journal subject: Vascular Diseases / Brain Year: 2022 Document Type: Article