Risk of Ischemic Stroke in Patients With Coronavirus Disease 2019 (COVID-19) vs Patients With Influenza.
JAMA Neurol
; 2020 Jul 02.
Article
in English
| MEDLINE | ID: covidwho-627768
Semantic information from SemMedBD (by NLM)
1. Influenza PROCESS_OF Patients
2. Ischemic stroke PROCESS_OF Patients
3. COVID-19 PREDISPOSES Ischemic stroke
4. American College of Cardiology/American Heart Association Lesion Complexity Score C COEXISTS_WITH COVID-19
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American College of Cardiology/American Heart Association Lesion Complexity Score C + COEXISTS_WITH COEXISTS_WITH + COVID-19 American College of Cardiology/American Heart Association Lesion Complexity Score C + COVID-19 American College of Cardiology/American Heart Association Lesion Complexity Score C + COEXISTS_WITH + COVID-19
5. Cerebrovascular accident COEXISTS_WITH Respiratory viruses
6. COVID-19 PROCESS_OF Patients
7. Nasopharynx LOCATION_OF 2019 novel coronavirus
8. Acute Cerebrovascular Accidents PROCESS_OF Patients
9. Cerebrovascular accident PROCESS_OF Patients
10. Blood Vessel LOCATION_OF risk factors
11. Ischemic stroke PROCESS_OF Adult
12. COVID-19 PROCESS_OF Adult
13. Hospitals LOCATION_OF Retrospective Cohort Study
14. COVID-19 COEXISTS_WITH Thrombus
15. Influenza PROCESS_OF Patients
16. Ischemic stroke PROCESS_OF Patients
17. COVID-19 PREDISPOSES Ischemic stroke
18. American College of Cardiology/American Heart Association Lesion Complexity Score C COEXISTS_WITH COVID-19
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American College of Cardiology/American Heart Association Lesion Complexity Score C + COEXISTS_WITH COEXISTS_WITH + COVID-19 American College of Cardiology/American Heart Association Lesion Complexity Score C + COVID-19 American College of Cardiology/American Heart Association Lesion Complexity Score C + COEXISTS_WITH + COVID-19
American College of Cardiology/American Heart Association Lesion Complexity Score C + COEXISTS_WITH COEXISTS_WITH + COVID-19 American College of Cardiology/American Heart Association Lesion Complexity Score C + COVID-19 American College of Cardiology/American Heart Association Lesion Complexity Score C + COEXISTS_WITH + COVID-19
19. Cerebrovascular accident COEXISTS_WITH Respiratory viruses
20. COVID-19 PROCESS_OF Patients
21. Nasopharynx LOCATION_OF 2019 novel coronavirus
22. Acute Cerebrovascular Accidents PROCESS_OF Patients
23. Cerebrovascular accident PROCESS_OF Patients
24. Blood Vessel LOCATION_OF risk factors
25. Ischemic stroke PROCESS_OF Adult
26. COVID-19 PROCESS_OF Adult
27. Hospitals LOCATION_OF Retrospective Cohort Study
28. COVID-19 COEXISTS_WITH Thrombus
ABSTRACT
IMPORTANCE It is uncertain whether coronavirus disease 2019 (COVID-19) is associated with a higher risk of ischemic stroke than would be expected from a viral respiratory infection. OBJECTIVE:
To compare the rate of ischemic stroke between patients with COVID-19 and patients with influenza, a respiratory viral illness previously associated with stroke. DESIGN, SETTING, ANDPARTICIPANTS:
This retrospective cohort study was conducted at 2 academic hospitals in New York City, New York, and included adult patients with emergency department visits or hospitalizations with COVID-19 from March 4, 2020, through May 2, 2020. The comparison cohort included adults with emergency department visits or hospitalizations with influenza A/B from January 1, 2016, through May 31, 2018 (spanning moderate and severe influenza seasons). EXPOSURES COVID-19 infection confirmed by evidence of severe acute respiratory syndrome coronavirus 2 in the nasopharynx by polymerase chain reaction and laboratory-confirmed influenza A/B. MAIN OUTCOMES ANDMEASURES:
A panel of neurologists adjudicated the primary outcome of acute ischemic stroke and its clinical characteristics, mechanisms, and outcomes. We used logistic regression to compare the proportion of patients with COVID-19 with ischemic stroke vs the proportion among patients with influenza.RESULTS:
Among 1916 patients with emergency department visits or hospitalizations with COVID-19, 31 (1.6%; 95% CI, 1.1%-2.3%) had an acute ischemic stroke. The median age of patients with stroke was 69 years (interquartile range, 66-78 years); 18 (58%) were men. Stroke was the reason for hospital presentation in 8 cases (26%). In comparison, 3 of 1486 patients with influenza (0.2%; 95% CI, 0.0%-0.6%) had an acute ischemic stroke. After adjustment for age, sex, and race, the likelihood of stroke was higher with COVID-19 infection than with influenza infection (odds ratio, 7.6; 95% CI, 2.3-25.2). The association persisted across sensitivity analyses adjusting for vascular risk factors, viral symptomatology, and intensive care unit admission. CONCLUSIONS AND RELEVANCE In this retrospective cohort study from 2 New York City academic hospitals, approximately 1.6% of adults with COVID-19 who visited the emergency department or were hospitalized experienced ischemic stroke, a higher rate of stroke compared with a cohort of patients with influenza. Additional studies are needed to confirm these findings and to investigate possible thrombotic mechanisms associated with COVID-19.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Etiology study
/
Observational study
/
Risk factors
Topics:
Long Covid
Language:
English
Year:
2020
Document Type:
Article
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