Characteristics of a COVID-19 Cohort With Large Vessel Occlusion: A Multicenter International Study.
Neurosurgery
; 90(6): 725-733, 2022 06 01.
Article
in English
| MEDLINE | ID: covidwho-2109255
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.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Brain Ischemia
/
Stroke
/
COVID-19
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Neurosurgery
Year:
2022
Document Type:
Article
Affiliation country:
Neu.0000000000001902
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