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Ischemic Stroke Occurs Less Frequently in Patients With COVID-19: A Multicenter Cross-Sectional Study.
Bekelis, Kimon; Missios, Symeon; Ahmad, Javaad; Labropoulos, Nicos; Schirmer, Clemens M; Calnan, Daniel R; Skinner, Jonathan; MacKenzie, Todd A.
  • Bekelis K; The Stroke and Brain Aneurysm Center of Long Island, Babylon, NY (K.B.).
  • Missios S; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH (K.B., J.S., T.A.M.).
  • Ahmad J; Population Health Research Institute of New York, Melville, NY (K.B., S.M., J.A., T.A.M.).
  • Labropoulos N; Division of Neurosurgery, Good Samaritan Hospital Medical Center, West Islip, NY (K.B., S.M., J.A.).
  • Schirmer CM; Population Health Research Institute of New York, Melville, NY (K.B., S.M., J.A., T.A.M.).
  • Calnan DR; Division of Neurosurgery, Good Samaritan Hospital Medical Center, West Islip, NY (K.B., S.M., J.A.).
  • Skinner J; Population Health Research Institute of New York, Melville, NY (K.B., S.M., J.A., T.A.M.).
  • MacKenzie TA; Division of Neurosurgery, Good Samaritan Hospital Medical Center, West Islip, NY (K.B., S.M., J.A.).
Stroke ; 51(12): 3570-3576, 2020 12.
Article in English | MEDLINE | ID: covidwho-892327
Semantic information from SemMedBD (by NLM)
1. Ischemic stroke OCCURS_IN Patients
Subject
Ischemic stroke
Predicate
OCCURS_IN
Object
Patients
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. Ischemic stroke COEXISTS_WITH COVID-19
Subject
Ischemic stroke
Predicate
COEXISTS_WITH
Object
COVID-19
4. Cerebrovascular accident PROCESS_OF Patients
Subject
Cerebrovascular accident
Predicate
PROCESS_OF
Object
Patients
5. COVID-19 COEXISTS_WITH Acute Cerebrovascular Accidents
Subject
COVID-19
Predicate
COEXISTS_WITH
Object
Acute Cerebrovascular Accidents
6. COVID-19 PROCESS_OF Young Adult
Subject
COVID-19
Predicate
PROCESS_OF
Object
Young Adult
7. Cerebrovascular accident PROCESS_OF Young Adult
Subject
Cerebrovascular accident
Predicate
PROCESS_OF
Object
Young Adult
8. Ischemic stroke OCCURS_IN Patients
Subject
Ischemic stroke
Predicate
OCCURS_IN
Object
Patients
9. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
10. Ischemic stroke COEXISTS_WITH COVID-19
Subject
Ischemic stroke
Predicate
COEXISTS_WITH
Object
COVID-19
11. Cerebrovascular accident PROCESS_OF Patients
Subject
Cerebrovascular accident
Predicate
PROCESS_OF
Object
Patients
12. COVID-19 COEXISTS_WITH Acute Cerebrovascular Accidents
Subject
COVID-19
Predicate
COEXISTS_WITH
Object
Acute Cerebrovascular Accidents
13. COVID-19 PROCESS_OF Young Adult
Subject
COVID-19
Predicate
PROCESS_OF
Object
Young Adult
14. Cerebrovascular accident PROCESS_OF Young Adult
Subject
Cerebrovascular accident
Predicate
PROCESS_OF
Object
Young Adult
ABSTRACT
BACKGROUND AND

PURPOSE:

The impact of coronavirus disease 2019 (COVID-19) on the occurrence of ischemic stroke has been the subject of increased speculation but has not been confirmed in large observational studies. We investigated the association between COVID-19 and stroke.

METHODS:

We performed a cross-sectional study involving patients discharged from a healthcare system in New York State, from January to April 2020. A mixed-effects logistic regression analysis and a propensity score-weighted analysis were used to control for confounders and investigate the association of COVID-19 with ischemic stroke. Similar techniques were used to detect the impact of concurrent COVID-19 infection on unfavorable outcomes for patients with stroke.

RESULTS:

Among 24 808 discharges, 2513 (10.1%) were diagnosed with COVID-19, and 566 (0.2%) presented with acute ischemic stroke. Patients diagnosed with COVID-19 were at one-quarter the odds of stroke compared with other patients (odds ratio, 0.25 [95% CI, 0.16-0.40]). This association was consistent in all age groups. Our results were robust in sensitivity analyses, including propensity score-weighted regression models. In patients presenting with stroke, concurrent infection with severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) was associated with higher case-fatality (odds ratio, 10.50 [95% CI, 3.54-31.18]) and a trend towards increased occurrence of discharge to rehabilitation (odds ratio, 2.45 [95% CI, 0.81-1.25]).

CONCLUSIONS:

Using a comprehensive cross-section of patients from a large NY-based healthcare system, we did not identify a positive association between ischemic stroke and COVID-19. However, patients with stroke with COVID-19 had worse outcomes compared with those without, with over a 9-fold increase in mortality. Although no definitive conclusions can be reached from our observational study, our data do not support the concerns for an epidemic of stroke in young adults with COVID-19.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Ischemic Stroke / COVID-19 Type of study: Controlled clinical trial / Etiology study / Observational study / Prevalence study / Prognostic study / Randomized controlled trials / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Stroke Year: 2020 Document Type: Article

Full text: Available Collection: International databases Database: MEDLINE Main subject: Ischemic Stroke / COVID-19 Type of study: Controlled clinical trial / Etiology study / Observational study / Prevalence study / Prognostic study / Randomized controlled trials / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Stroke Year: 2020 Document Type: Article