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Risk of stroke in hospitalized SARS-CoV-2 infected patients: A multinational study.
Shahjouei, Shima; Naderi, Soheil; Li, Jiang; Khan, Ayesha; Chaudhary, Durgesh; Farahmand, Ghasem; Male, Shailesh; Griessenauer, Christoph; Sabra, Mirna; Mondello, Stefania; Cernigliaro, Achille; Khodadadi, Faezeh; Dev, Apoorva; Goyal, Nitin; Ranji-Burachaloo, Sakineh; Olulana, Oluwaseyi; Avula, Venkatesh; Ebrahimzadeh, Seyed Amir; Alizada, Orkhan; Hanci, Mehmet Murat; Ghorbani, Askar; Vaghefi Far, Alaleh; Ranta, Annemarei; Punter, Martin; Ramezani, Mahtab; Ostadrahimi, Nima; Tsivgoulis, Georgios; Fragkou, Paraskevi C; Nowrouzi-Sohrabi, Peyman; Karofylakis, Emmanouil; Tsiodras, Sotirios; Neshin Aghayari Sheikh, Saeideh; Saberi, Alia; Niemelä, Mika; Rezai Jahromi, Behnam; Mowla, Ashkan; Mashayekhi, Mahsa; Bavarsad Shahripour, Reza; Sajedi, Seyed Aidin; Ghorbani, Mohammad; Kia, Arash; Rahimian, Nasrin; Abedi, Vida; Zand, Ramin.
  • Shahjouei S; Neurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA.
  • Naderi S; Neurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA; Neurosurgery Department, Tehran University of Medical Sciences, Tehran, Iran.
  • Li J; Department of Molecular and Functional Genomics, Geisinger Health System, Danville, PA, USA.
  • Khan A; Neurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA.
  • Chaudhary D; Neurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA.
  • Farahmand G; Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Neurology Department, Tehran University of Medical Sciences, Tehran, Iran.
  • Male S; Neurology Department, Vidant Medical Center, Greenville, NC, USA.
  • Griessenauer C; Neurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA.
  • Sabra M; Neurosciences Research Center (NRC), Lebanese University/ Medical School, Beirut, Lebanon.
  • Mondello S; Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
  • Cernigliaro A; Regional Health Authority of Sicily, Palermo, Italy.
  • Khodadadi F; PES University, Bengaluru, Karnataka, India.
  • Dev A; PES University, Bengaluru, Karnataka, India.
  • Goyal N; Neurology Department, University of Tennessee Health Science Center, Tennessee, USA.
  • Ranji-Burachaloo S; Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Neurology Department, Tehran University of Medical Sciences, Tehran, Iran.
  • Olulana O; Neurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA.
  • Avula V; Neurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA.
  • Ebrahimzadeh SA; Radiology Department, Yasrebi Hospital, Kashan, Iran.
  • Alizada O; Neurosurgery Department, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey.
  • Hanci MM; Neurosurgery Department, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey.
  • Ghorbani A; Neurology Department, Tehran University of Medical Sciences, Tehran, Iran.
  • Vaghefi Far A; Department of Neurology, Wellington Hospital, Wellington, New Zealand.
  • Ranta A; Department of Neurology, Wellington Hospital, Wellington, New Zealand; Department of Medicine, University of Otago, Wellington, New Zealand.
  • Punter M; Department of Neurology, Wellington Hospital, Wellington, New Zealand; Department of Medicine, University of Otago, Wellington, New Zealand.
  • Ramezani M; Neurology Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Ostadrahimi N; Neurosurgery Department, Tehran University of Medical Sciences, Tehran, Iran.
  • Tsivgoulis G; Neurology Department, University of Tennessee Health Science Center, Tennessee, USA; Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, "Attikon" University Hospital, Athens, Greece.
  • Fragkou PC; Fourth Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
  • Nowrouzi-Sohrabi P; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
  • Karofylakis E; Fourth Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
  • Tsiodras S; Fourth Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
  • Neshin Aghayari Sheikh S; Neurology Department, Poursina Hospital, Guilan University of Medical Sciences, Guilan, Iran.
  • Saberi A; Neurology Department, Poursina Hospital, Guilan University of Medical Sciences, Guilan, Iran.
  • Niemelä M; Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland.
  • Rezai Jahromi B; Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland.
  • Mowla A; Division of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California, California, USA.
  • Mashayekhi M; Internal medicine Department, Tabriz University of medical sciences, Tabriz, Iran.
  • Bavarsad Shahripour R; Neurology Department, University of Tennessee Health Science Center, Tennessee, USA.
  • Sajedi SA; Neuroscience Research Center, Department of Neurology, Golestan University of Medical Sciences, Gorgan, Iran.
  • Ghorbani M; Divisions of Vascular and Endovascular Neurosurgery and Neurology, Firoozgar Hospital and Rasoul-Akram hospital, Iran University of Medical Sciences, Tehran, Iran.
  • Kia A; Icahn school of medicine at Mount Sinai, Department of Population Health Science and Policy, Institute for Healthcare Delivery Science, New York, USA.
  • Rahimian N; Neurology Department, Yasrebi Hospital, Kashan, Iran.
  • Abedi V; Department of Molecular and Functional Genomics, Geisinger Health System, Danville, PA, USA; Biocomplexity Institute, Virginia Tech, Blacksburg, Virginia, USA.
  • Zand R; Neurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA; Neurology Department, University of Tennessee Health Science Center, Tennessee, USA. Electronic address: rzand@geisinger.edu.
EBioMedicine ; 59: 102939, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-716658
Semantic information from SemMedBD (by NLM)
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ABSTRACT

BACKGROUND:

There is an increased attention to stroke following SARS-CoV-2. The goal of this study was to better depict the short-term risk of stroke and its associated factors among SARS-CoV-2 hospitalized patients.

METHODS:

This multicentre, multinational observational study includes hospitalized SARS-CoV-2 patients from North and South America (United States, Canada, and Brazil), Europe (Greece, Italy, Finland, and Turkey), Asia (Lebanon, Iran, and India), and Oceania (New Zealand). The outcome was the risk of subsequent stroke. Centres were included by non-probability sampling. The counts and clinical characteristics including laboratory findings and imaging of the patients with and without a subsequent stroke were recorded according to a predefined protocol. Quality, risk of bias, and heterogeneity assessments were conducted according to ROBINS-E and Cochrane Q-test. The risk of subsequent stroke was estimated through meta-analyses with random effect models. Bivariate logistic regression was used to determine the parameters with predictive outcome value. The study was reported according to the STROBE, MOOSE, and EQUATOR guidelines.

FINDINGS:

We received data from 26,175 hospitalized SARS-CoV-2 patients from 99 tertiary centres in 65 regions of 11 countries until May 1st, 2020. A total of 17,799 patients were included in meta-analyses. Among them, 156(0.9%) patients had a stroke-123(79%) ischaemic stroke, 27(17%) intracerebral/subarachnoid hemorrhage, and 6(4%) cerebral sinus thrombosis. Subsequent stroke risks calculated with meta-analyses, under low to moderate heterogeneity, were 0.5% among all centres in all countries, and 0.7% among countries with higher health expenditures. The need for mechanical ventilation (OR 1.9, 95% CI1.1-3.5, p = 0.03) and the presence of ischaemic heart disease (OR 2.5, 95% CI1.4-4.7, p = 0.006) were predictive of stroke.

INTERPRETATION:

The results of this multi-national study on hospitalized patients with SARS-CoV-2 infection indicated an overall stroke risk of 0.5%(pooled risk 0.9%). The need for mechanical ventilation and the history of ischaemic heart disease are the independent predictors of stroke among SARS-CoV-2 patients.

FUNDING:

None.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Stroke Type of study: Etiology study / Clinical Practice Guide / Prognostic study / Randomized controlled trials / Reviews / Risk factors Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: EBioMedicine Year: 2020 Document Type: Article Affiliation country: J.ebiom.2020.102939

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Stroke Type of study: Etiology study / Clinical Practice Guide / Prognostic study / Randomized controlled trials / Reviews / Risk factors Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: EBioMedicine Year: 2020 Document Type: Article Affiliation country: J.ebiom.2020.102939