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Cerebrovascular events and outcomes in hospitalized patients with COVID-19: The SVIN COVID-19 Multinational Registry.
Siegler, James E; Cardona, Pere; Arenillas, Juan F; Talavera, Blanca; Guillen, Ana N; Chavarría-Miranda, Alba; de Lera, Mercedes; Khandelwal, Priyank; Bach, Ivo; Patel, Pratit; Singla, Amit; Requena, Manuel; Ribo, Marc; Jillella, Dinesh V; Rangaraju, Srikant; Nogueira, Raul G; Haussen, Diogo C; Vazquez, Alejandro R; Urra, Xabier; Chamorro, Ángel; Román, Luis S; Thon, Jesse M; Then, Ryna; Sanborn, Emma; de la Ossa, Natalia P; Millàn, Mònica; Ruiz, Isaac N; Mansour, Ossama Y; Megahed, Mohammed; Tiu, Cristina; Terecoasa, Elena O; Radu, Razvan A; Nguyen, Thanh N; Curiale, Gioacchino; Kaliaev, Artem; Czap, Alexandra L; Sebaugh, Jacob; Zha, Alicia M; Liebeskind, David S; Ortega-Gutierrez, Santiago; Farooqui, Mudassir; Hassan, Ameer E; Preston, Laurie; Patterson, Mary S; Bushnaq, Saif; Zaidat, Osama; Jovin, Tudor G.
  • Siegler JE; Cooper Neurologic Institute, Cooper University Hospital, Camden, NJ, USA.
  • Cardona P; Cooper Medical School of Rowan University, Camden NJ, USA.
  • Arenillas JF; Department of Neurology, Hospital Universitari, Bellvitge, Barcelona, Spain.
  • Talavera B; Department of Neurology, Hospital Clínico Universitario, Valladolid, Spain.
  • Guillen AN; Neurovascular Research Laboratory, Instituto de Biología y Genética Molecular, Universidad de Valladolid, Consejo Superior de Investigaciones Científicas, Madrid, Spain.
  • Chavarría-Miranda A; Department of Neurology, Hospital Universitari, Bellvitge, Barcelona, Spain.
  • de Lera M; Department of Neurology, Hospital Universitari, Bellvitge, Barcelona, Spain.
  • Khandelwal P; Department of Neurology, Hospital Universitari, Bellvitge, Barcelona, Spain.
  • Bach I; Department of Neurology, Hospital Universitari, Bellvitge, Barcelona, Spain.
  • Patel P; Neurovascular Research Laboratory, Instituto de Biología y Genética Molecular, Universidad de Valladolid, Consejo Superior de Investigaciones Científicas, Madrid, Spain.
  • Singla A; Department of Neurology, Robert Wood Johnson University Hospital, New Brunswick, NJ, USA.
  • Requena M; Neurovascular Research Laboratory, Instituto de Biología y Genética Molecular, Universidad de Valladolid, Consejo Superior de Investigaciones Científicas, Madrid, Spain.
  • Ribo M; New Jersey Medical School, Newark, NJ, USA.
  • Jillella DV; Department of Neurosurgery, Robert Wood Johnson University Hospital, New Brunswick, NJ, USA.
  • Rangaraju S; Stroke Unit, Department of Neurology, Vall d'Hebron Research Institute, Barcelona, Spain.
  • Nogueira RG; Department of Neurosurgery, Robert Wood Johnson University Hospital, New Brunswick, NJ, USA.
  • Haussen DC; Stroke Unit, Department of Neurology, Vall d'Hebron Research Institute, Barcelona, Spain.
  • Vazquez AR; Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain.
  • Urra X; Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain.
  • Chamorro Á; Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain.
  • Román LS; Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
  • Thon JM; Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain.
  • Then R; Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
  • Sanborn E; Department of Neurology, Grady Memorial Hospital, Atlanta, GA, USA.
  • de la Ossa NP; Department of Neurology, Grady Memorial Hospital, Atlanta, GA, USA.
  • Millàn M; Department of Neurology, Hospital Clínic, Barcelona, Spain.
  • Ruiz IN; Department of Neurology, Grady Memorial Hospital, Atlanta, GA, USA.
  • Mansour OY; Department of Neurology, Hospital Clínic, Barcelona, Spain.
  • Megahed M; Area of Neuroscience, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.
  • Tiu C; Cooper Neurologic Institute, Cooper University Hospital, Camden, NJ, USA.
  • Terecoasa EO; Cooper Medical School of Rowan University, Camden NJ, USA.
  • Radu RA; Cooper Neurologic Institute, Cooper University Hospital, Camden, NJ, USA.
  • Nguyen TN; Cooper Medical School of Rowan University, Camden NJ, USA.
  • Curiale G; Cooper Neurologic Institute, Cooper University Hospital, Camden, NJ, USA.
  • Kaliaev A; Cooper Medical School of Rowan University, Camden NJ, USA.
  • Czap AL; Department of Radiology, Hospital Clínic, Barcelona, Spain.
  • Sebaugh J; Department of Radiology, Hospital Clínic, Barcelona, Spain.
  • Zha AM; Department of Radiology, Hospital Clínic, Barcelona, Spain.
  • Liebeskind DS; Stroke Unit, Neuroscience Department, Hospital Universitari Germans Trias i Pujol, Carretera Canyet s/n, Badalona, Barcelona, Spain.
  • Ortega-Gutierrez S; Department of Neurology, Stroke and Neurointervention division, Alexandria University, Alexandria, Egypt.
  • Farooqui M; Department of Critical Care Medicine, Alexandria University, Alexandria, Egypt.
  • Hassan AE; Department of Neurology, University Emergency Hospital Bucharest, Bucharest, Romania.
  • Preston L; Department of Critical Care Medicine, Alexandria University, Alexandria, Egypt.
  • Patterson MS; Department of Neurology, University Emergency Hospital Bucharest, Bucharest, Romania.
  • Bushnaq S; Department of Critical Care Medicine, Alexandria University, Alexandria, Egypt.
  • Zaidat O; "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
  • Jovin TG; Department of Neurology, Boston Medical Center, Boston University School of Medicine, MA, USA.
Int J Stroke ; 16(4): 437-447, 2021 06.
Article in English | MEDLINE | ID: covidwho-806135
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF hospitalized patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
hospitalized patients
2. COVID-19 PROCESS_OF hospitalized patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
hospitalized patients
ABSTRACT

BACKGROUND:

Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has been associated with a significant risk of thrombotic events in critically ill patients.

AIM:

To summarize the findings of a multinational observational cohort of patients with SARS-CoV-2 and cerebrovascular disease.

METHODS:

Retrospective observational cohort of consecutive adults evaluated in the emergency department and/or admitted with coronavirus disease 2019 (COVID-19) across 31 hospitals in four countries (1 February 2020-16 June 2020). The primary outcome was the incidence rate of cerebrovascular events, inclusive of acute ischemic stroke, intracranial hemorrhages (ICH), and cortical vein and/or sinus thrombosis (CVST).

RESULTS:

Of the 14,483 patients with laboratory-confirmed SARS-CoV-2, 172 were diagnosed with an acute cerebrovascular event (1.13% of cohort; 1130/100,000 patients, 95%CI 970-1320/100,000), 68/171 (40.5%) were female and 96/172 (55.8%) were between the ages 60 and 79 years. Of these, 156 had acute ischemic stroke (1.08%; 1080/100,000 95%CI 920-1260/100,000), 28 ICH (0.19%; 190/100,000 95%CI 130-280/100,000), and 3 with CVST (0.02%; 20/100,000, 95%CI 4-60/100,000). The in-hospital mortality rate for SARS-CoV-2-associated stroke was 38.1% and for ICH 58.3%. After adjusting for clustering by site and age, baseline stroke severity, and all predictors of in-hospital mortality found in univariate regression (p < 0.1 male sex, tobacco use, arrival by emergency medical services, lower platelet and lymphocyte counts, and intracranial occlusion), cryptogenic stroke mechanism (aOR 5.01, 95%CI 1.63-15.44, p < 0.01), older age (aOR 1.78, 95%CI 1.07-2.94, p = 0.03), and lower lymphocyte count on admission (aOR 0.58, 95%CI 0.34-0.98, p = 0.04) were the only independent predictors of mortality among patients with stroke and COVID-19.

CONCLUSIONS:

COVID-19 is associated with a small but significant risk of clinically relevant cerebrovascular events, particularly ischemic stroke. The mortality rate is high for COVID-19-associated cerebrovascular complications; therefore, aggressive monitoring and early intervention should be pursued to mitigate poor outcomes.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Cerebrovascular Disorders / COVID-19 Type of study: Controlled clinical trial / Etiology study / Incidence study / Observational study / Prevalence study / Prognostic study / Risk factors Limits: Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Journal: Int J Stroke Year: 2021 Document Type: Article Affiliation country: 1747493020959216

Full text: Available Collection: International databases Database: MEDLINE Main subject: Cerebrovascular Disorders / COVID-19 Type of study: Controlled clinical trial / Etiology study / Incidence study / Observational study / Prevalence study / Prognostic study / Risk factors Limits: Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Journal: Int J Stroke Year: 2021 Document Type: Article Affiliation country: 1747493020959216