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The Impact of SARS-CoV-2 on Stroke Epidemiology and Care: A Meta-Analysis.
Katsanos, Aristeidis H; Palaiodimou, Lina; Zand, Ramin; Yaghi, Shadi; Kamel, Hooman; Navi, Babak B; Turc, Guillaume; Romoli, Michele; Sharma, Vijay K; Mavridis, Dimitris; Shahjouei, Shima; Catanese, Luciana; Shoamanesh, Ashkan; Vadikolias, Konstantinos; Tsioufis, Konstantinos; Lagiou, Pagona; Alexandrov, Andrei V; Tsiodras, Sotirios; Tsivgoulis, Georgios.
  • Katsanos AH; Division of Neurology, McMaster University/Population Health Research Institute, Hamilton, Ontario, Canada.
  • Palaiodimou L; Second Department of Neurology, Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
  • Zand R; Second Department of Neurology, Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
  • Yaghi S; Neuroscience Institute, Geisinger Health System, Danville, PA.
  • Kamel H; Department of Neurology, NYU Langone Health, New York, NY.
  • Navi BB; Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY.
  • Turc G; Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY.
  • Romoli M; Department of Neurology, Paris Psychiatry and Neurosciences University Hospital Group, Sainte Anne Hospital, Paris, France.
  • Sharma VK; University of Paris, Paris, France.
  • Mavridis D; INSERM U1266, Paris, France.
  • Shahjouei S; FHU Neurovasc, Paris, France.
  • Catanese L; Neurology Unit, Maurizio Bufalini Hospital, Cesena, Italy.
  • Shoamanesh A; Neurology Clinic, University of Perugia-S. Maria del la Misericordia Hospital, Perugia, Italy.
  • Vadikolias K; Division of Neurology, Department of Medicine, National University Hospital, Singapore and School of Medicine, National University of Singapore, Singapore.
  • Tsioufis K; Department of Primary Education, University of Ioannina, Ioannina, Greece.
  • Lagiou P; Faculty of Medicine, Paris Descartes University, Paris, France.
  • Alexandrov AV; Neuroscience Institute, Geisinger Health System, Danville, PA.
  • Tsiodras S; Division of Neurology, McMaster University/Population Health Research Institute, Hamilton, Ontario, Canada.
  • Tsivgoulis G; Division of Neurology, McMaster University/Population Health Research Institute, Hamilton, Ontario, Canada.
Ann Neurol ; 89(2): 380-388, 2021 02.
Article in English | MEDLINE | ID: covidwho-938391
Semantic information from SemMedBD (by NLM)
1. IMPACT gene PART_OF 2019 novel coronavirus
Subject
IMPACT gene
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PART_OF
Object
2019 novel coronavirus
2. 2019 novel coronavirus PROCESS_OF Patients
Subject
2019 novel coronavirus
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PROCESS_OF
Object
Patients
3. COVID-19 PROCESS_OF Patients
Subject
COVID-19
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PROCESS_OF
Object
Patients
4. Cerebrovascular accident PROCESS_OF Patients
Subject
Cerebrovascular accident
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PROCESS_OF
Object
Patients
5. Diabetes Mellitus PROCESS_OF Patients
Subject
Diabetes Mellitus
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PROCESS_OF
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Patients
6. Ischemic stroke PROCESS_OF hospitalized patients
Subject
Ischemic stroke
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PROCESS_OF
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hospitalized patients
7. COVID-19 PROCESS_OF hospitalized patients
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COVID-19
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PROCESS_OF
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hospitalized patients
8. IMPACT gene PART_OF 2019 novel coronavirus
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PART_OF
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2019 novel coronavirus
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Patients
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Subject
COVID-19
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PROCESS_OF
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Patients
11. Cerebrovascular accident PROCESS_OF Patients
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Cerebrovascular accident
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PROCESS_OF
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Patients
12. Diabetes Mellitus PROCESS_OF Patients
Subject
Diabetes Mellitus
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Patients
13. Ischemic stroke PROCESS_OF hospitalized patients
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hospitalized patients
14. COVID-19 PROCESS_OF hospitalized patients
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COVID-19
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ABSTRACT

OBJECTIVE:

Emerging data indicate an increased risk of cerebrovascular events with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and highlight the potential impact of coronavirus disease (COVID-19) on the management and outcomes of acute stroke. We conducted a systematic review and meta-analysis to evaluate the aforementioned considerations.

METHODS:

We performed a meta-analysis of observational cohort studies reporting on the occurrence and/or outcomes of patients with cerebrovascular events in association with their SARS-CoV-2 infection status. We used a random-effects model. Summary estimates were reported as odds ratios (ORs) and corresponding 95% confidence intervals (CIs).

RESULTS:

We identified 18 cohort studies including 67,845 patients. Among patients with SARS-CoV-2, 1.3% (95% CI = 0.9-1.6%, I2 = 87%) were hospitalized for cerebrovascular events, 1.1% (95% CI = 0.8-1.3%, I2 = 85%) for ischemic stroke, and 0.2% (95% CI = 0.1-0.3%, I2 = 64%) for hemorrhagic stroke. Compared to noninfected contemporary or historical controls, patients with SARS-CoV-2 infection had increased odds of ischemic stroke (OR = 3.58, 95% CI = 1.43-8.92, I2 = 43%) and cryptogenic stroke (OR = 3.98, 95% CI = 1.62-9.77, I2 = 0%). Diabetes mellitus was found to be more prevalent among SARS-CoV-2 stroke patients compared to noninfected historical controls (OR = 1.39, 95% CI = 1.00-1.94, I2 = 0%). SARS-CoV-2 infection status was not associated with the likelihood of receiving intravenous thrombolysis (OR = 1.42, 95% CI = 0.65-3.10, I2 = 0%) or endovascular thrombectomy (OR = 0.78, 95% CI = 0.35-1.74, I2 = 0%) among hospitalized ischemic stroke patients during the COVID-19 pandemic. Odds of in-hospital mortality were higher among SARS-CoV-2 stroke patients compared to noninfected contemporary or historical stroke patients (OR = 5.60, 95% CI = 3.19-9.80, I2 = 45%).

INTERPRETATION:

SARS-CoV-2 appears to be associated with an increased risk of ischemic stroke, and potentially cryptogenic stroke in particular. It may also be related to an increased mortality risk. ANN NEUROL 2021;89380-388.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Hospital Mortality / Stroke / Diabetes Mellitus / SARS-CoV-2 / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials / Reviews / Risk factors / Screening study / Systematic review Limits: Humans Language: English Journal: Ann Neurol Year: 2021 Document Type: Article Affiliation country: Ana.25967

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hospital Mortality / Stroke / Diabetes Mellitus / SARS-CoV-2 / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials / Reviews / Risk factors / Screening study / Systematic review Limits: Humans Language: English Journal: Ann Neurol Year: 2021 Document Type: Article Affiliation country: Ana.25967