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Predictors of mortality for patients with COVID-19 and large vessel occlusion.
Altschul, David J; Esenwa, Charles; Haranhalli, Neil; Unda, Santiago R; de La Garza Ramos, Rafael; Dardick, Joseph; Fernandez-Torres, Jenelys; Toma, Aureliana; Labovitz, Daniel; Cheng, Natalie; Lee, Seon-Kyu; Brook, Allan; Zampolin, Richard.
  • Altschul DJ; Department of Neurosurgery Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA.
  • Esenwa C; Department of Neurology Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA.
  • Haranhalli N; Department of Neurosurgery Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA.
  • Unda SR; Department of Neurosurgery Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA.
  • de La Garza Ramos R; Department of Neurosurgery Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA.
  • Dardick J; Albert Einstein College of Medicine, New York, NY, USA.
  • Fernandez-Torres J; Department of Neurosurgery Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA.
  • Toma A; Department of Neurosurgery Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA.
  • Labovitz D; Department of Radiology Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA.
  • Cheng N; Department of Radiology Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA.
  • Lee SK; Department of Radiology Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA.
  • Brook A; Department of Radiology Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA.
  • Zampolin R; Department of Radiology Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA.
Interv Neuroradiol ; 26(5): 623-628, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-736342
ABSTRACT

BACKGROUND:

This study evaluates the mortality risk of patients with emergent large vessel occlusion (ELVO) and COVID-19 during the pandemic.

METHODS:

We performed a retrospective cohort study of two cohorts of consecutive patients with ELVO admitted to a quaternary hospital from March 1 to April 17, 2020. We abstracted data from electronic health records on baseline, biomarker profiles, key time points, quality measures and radiographic data.

RESULTS:

Of 179 patients admitted with ischemic stroke, 36 had ELVO. Patients with COVID-19 and ELVO had a higher risk of mortality during the pandemic versus patients without COVID-19 (OR 16.63, p = 0.004). An age-based sub-analysis showed in-hospital mortality in 60% of COVID-19 positive patients between 61-70 years-old, 66.7% in between 51-60 years-old, 50% in between 41-50 years-old and 33.3% in between 31-40 years old. Patients that presented with pulmonary symptoms at time of stroke presentation had 71.4% mortality rate. 27.3% of COVID-19 patients presenting with ELVO had a good outcome at discharge (mRS 0-2). Patients with a history of cigarette smoking (p = 0.003), elevated d-dimer (p = 0.007), failure to recanalize (p = 0.007), and elevated ferritin levels (p = 0.006) had an increased risk of mortality.

CONCLUSION:

Patients with COVID-19 and ELVO had a significantly higher risk for mortality compared to COVID-19 negative patients with ELVO. A small percentage of COVID-19 ELVO patients had good outcomes. Age greater than 60 and pulmonary symptoms at presentation have higher risk for mortality. Other risk factors for mortality were a history of cigarette smoking, elevated, failure to recanalize, elevated d-dimer and ferritin levels.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Arterial Occlusive Diseases / Coronavirus Infections Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Interv Neuroradiol Journal subject: Neurology / Radiology Year: 2020 Document Type: Article Affiliation country: 1591019920954603

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Arterial Occlusive Diseases / Coronavirus Infections Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Interv Neuroradiol Journal subject: Neurology / Radiology Year: 2020 Document Type: Article Affiliation country: 1591019920954603