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European Multicenter Study of ET-COVID-19.
Cagnazzo, Federico; Piotin, Michel; Escalard, Simon; Maier, Benjamin; Ribo, Marc; Requena, Manuel; Pop, Raoul; Hasiu, Anca; Gasparotti, Roberto; Mardighian, Dikran; Piano, Mariangela; Cervo, Amedeo; Eker, Omer Faruk; Durous, Vincent; Sourour, Nader-Antoine; Elhorany, Mahmoud; Zini, Andrea; Simonetti, Luigi; Marcheselli, Simona; Paolo, Nuzzi Nunzio; Houdart, Emmanuel; Guédon, Alexis; Ligot, Noémie; Mine, Benjamin; Consoli, Arturo; Lapergue, Bertrand; Cordona Portela, Pere; Urra, Xabier; Rodriguez, Alejandro; Bolognini, Federico; Lebedinsky, Pablo Ariel; Pasco-Papon, Anne; Godard, Sophie; Marnat, Gaultier; Sibon, Igor; Limbucci, Nicola; Nencini, Patrizia; Nappini, Sergio; Saia, Valentina; Caldiera, Valentina; Romano, Daniele; Frauenfelder, Giulia; Gallesio, Ivan; Gola, Giuliano; Menozzi, Roberto; Genovese, Antonio; Terrana, Alberto; Giorgianni, Andrea; Cappellari, Manuel; Augelli, Raffaele.
  • Cagnazzo F; Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier, France (F. Cagnazzo, V. Costalat).
  • Piotin M; Interventional Neuroradiology Department, Rothschild Foundation Hospital, Paris, France (M. Piotin, S.E., B. Maier).
  • Escalard S; Interventional Neuroradiology Department, Rothschild Foundation Hospital, Paris, France (M. Piotin, S.E., B. Maier).
  • Maier B; Interventional Neuroradiology Department, Rothschild Foundation Hospital, Paris, France (M. Piotin, S.E., B. Maier).
  • Ribo M; Stroke Unit, Neurology, Hospital Vall d'Hebron, Barcelona, Catalonia, Spain (M. Ribo, M. Requena).
  • Requena M; Stroke Unit, Neurology, Hospital Vall d'Hebron, Barcelona, Catalonia, Spain (M. Ribo, M. Requena).
  • Pop R; Department of Interventional Neuroradiology, Strasbourg University Hospitals (R.P., A.H.).
  • Hasiu A; Department of Interventional Neuroradiology, Strasbourg University Hospitals (R.P., A.H.).
  • Gasparotti R; Neuroradiology and Stroke Units, Spedali Civili, Brescia, Italy (R.G., D.M.).
  • Mardighian D; Neuroradiology and Stroke Units, Spedali Civili, Brescia, Italy (R.G., D.M.).
  • Piano M; Department of Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (M. Piano, A. Cervo).
  • Cervo A; Department of Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (M. Piano, A. Cervo).
  • Eker OF; Department of Diagnostic and Interventional Neuroradiology, Hospices Civils, Lyon, France (O.F.E., V.D., F. Cotton).
  • Durous V; Department of Diagnostic and Interventional Neuroradiology, Hospices Civils, Lyon, France (O.F.E., V.D., F. Cotton).
  • Sourour NA; Department of Neuroradiology, Pitié Salpêtrière Hospital, Paris, France (N.-A.S., M.E.).
  • Elhorany M; Department of Neuroradiology, Pitié Salpêtrière Hospital, Paris, France (N.-A.S., M.E.).
  • Zini A; Department of Neurology and Stroke Center (A.Z.), IRCCS Istituto di Scienze Neurologiche di Bologna, Maggiore Hospital, Bologna, Italy.
  • Simonetti L; Neuroradiology Unit (L.S.), IRCCS Istituto di Scienze Neurologiche di Bologna, Maggiore Hospital, Bologna, Italy.
  • Marcheselli S; Neurologia d'Urgenza e Stroke Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy (S.M., N.N.P.).
  • Paolo NN; Neurologia d'Urgenza e Stroke Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy (S.M., N.N.P.).
  • Houdart E; Department of Neurology, Hôpital Lariboisière, University of Paris, France (E.H., A. Guédon).
  • Guédon A; Department of Neurology, Hôpital Lariboisière, University of Paris, France (E.H., A. Guédon).
  • Ligot N; Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium (N. Ligot, B. Mine).
  • Mine B; Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium (N. Ligot, B. Mine).
  • Consoli A; Department of Diagnostic and Therapeutic Neuroradiology, Hôpital Foch Suresnes FR, University of Versailles Saint Quentin-en-Yvelines, France (A. Consoli, B.L.).
  • Lapergue B; Department of Diagnostic and Therapeutic Neuroradiology, Hôpital Foch Suresnes FR, University of Versailles Saint Quentin-en-Yvelines, France (A. Consoli, B.L.).
  • Cordona Portela P; Stroke Unit, Hospital Universitario de Bellvitge, Barcelona, Spain (P.C.P.).
  • Urra X; Comprehensive Stroke Unit, Hospital Clínic de Barcelona, Catalonia, Spain (X.U., A.R.).
  • Rodriguez A; Comprehensive Stroke Unit, Hospital Clínic de Barcelona, Catalonia, Spain (X.U., A.R.).
  • Bolognini F; Interventional Neuroradiology Department, CHRU Colmar, France (F.B., P.A.L.).
  • Lebedinsky PA; Interventional Neuroradiology Department, CHRU Colmar, France (F.B., P.A.L.).
  • Pasco-Papon A; Department of Radiology, University Hospital of Angers, France (A.P.-P.).
  • Godard S; Department of Neurology, Angers University Hospital, France (S.G.).
  • Marnat G; Interventional Neuroradiology Department, CHRU Bordeaux, France (G.M.).
  • Sibon I; Stroke Unit, Department of Neurology, Bordeaux University, CHRU Bordeaux; France (I.S.).
  • Limbucci N; Department of Interventional Neuroradiology, University of Florence, Italy (N. Limbucci, S.N.).
  • Nencini P; Stroke Unit, Ospedale Careggi-University Hospital, Firenze, Italy (P.N.).
  • Nappini S; Department of Interventional Neuroradiology, University of Florence, Italy (N. Limbucci, S.N.).
  • Saia V; Neurology and Stroke Unit, Santa Corona Hospital, Pietra Ligure (V.S., V. Caldiera).
  • Caldiera V; Neurology and Stroke Unit, Santa Corona Hospital, Pietra Ligure (V.S., V. Caldiera).
  • Romano D; Department of Neuroradiology, "San Giovanni di Dio e Ruggi d'Aragona" Hospital, Salerno, Italy (D.R., G.F.).
  • Frauenfelder G; Department of Neuroradiology, "San Giovanni di Dio e Ruggi d'Aragona" Hospital, Salerno, Italy (D.R., G.F.).
  • Gallesio I; Department of Radiology, Azienda ospedaliera "SS Antonio e Biagio e C. Arrigo", Alessandria, Italy (I.G., G. Gola).
  • Gola G; Department of Radiology, Azienda ospedaliera "SS Antonio e Biagio e C. Arrigo", Alessandria, Italy (I.G., G. Gola).
  • Menozzi R; Headache Centre, Department of Medicine and Surgery, Parma, Italy (R.M., A. Genovese).
  • Genovese A; Headache Centre, Department of Medicine and Surgery, Parma, Italy (R.M., A. Genovese).
  • Terrana A; Department of Neuroradiology, ASST Sette Laghi, University of Insubria, Varese, Italy (A.T., A. Giorgianni).
  • Giorgianni A; Department of Neuroradiology, ASST Sette Laghi, University of Insubria, Varese, Italy (A.T., A. Giorgianni).
  • Cappellari M; Stroke Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy (M.C., R.A.).
  • Augelli R; Stroke Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy (M.C., R.A.).
Stroke ; 52(1): 31-39, 2021 01.
Article in English | MEDLINE | ID: covidwho-939945
Semantic information from SemMedBD (by NLM)
1. Mechanical thrombectomy TREATS Vascular occlusion
Subject
Mechanical thrombectomy
Predicate
TREATS
Object
Vascular occlusion
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. Vascular occlusion PROCESS_OF Patients
Subject
Vascular occlusion
Predicate
PROCESS_OF
Object
Patients
4. Mechanical thrombectomy TREATS COVID-19
Subject
Mechanical thrombectomy
Predicate
TREATS
Object
COVID-19
5. Mechanical thrombectomy TREATS Patients
Subject
Mechanical thrombectomy
Predicate
TREATS
Object
Patients
6. High Level PROCESS_OF Patients
Subject
High Level
Predicate
PROCESS_OF
Object
Patients
7. GJA1 gene|GJA1 ASSOCIATED_WITH Cerebrovascular accident
Subject
GJA1 gene|GJA1
Predicate
ASSOCIATED_WITH
Object
Cerebrovascular accident
8. aspartate STIMULATES Lactate Dehydrogenase
Subject
aspartate
Predicate
STIMULATES
Object
Lactate Dehydrogenase
9. Mechanical thrombectomy TREATS Vascular occlusion
Subject
Mechanical thrombectomy
Predicate
TREATS
Object
Vascular occlusion
10. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
11. Vascular occlusion PROCESS_OF Patients
Subject
Vascular occlusion
Predicate
PROCESS_OF
Object
Patients
12. Mechanical thrombectomy TREATS COVID-19
Subject
Mechanical thrombectomy
Predicate
TREATS
Object
COVID-19
13. Mechanical thrombectomy TREATS Patients
Subject
Mechanical thrombectomy
Predicate
TREATS
Object
Patients
14. High Level PROCESS_OF Patients
Subject
High Level
Predicate
PROCESS_OF
Object
Patients
15. GJA1 gene|GJA1 ASSOCIATED_WITH Cerebrovascular accident
Subject
GJA1 gene|GJA1
Predicate
ASSOCIATED_WITH
Object
Cerebrovascular accident
16. aspartate STIMULATES Lactate Dehydrogenase
Subject
aspartate
Predicate
STIMULATES
Object
Lactate Dehydrogenase
ABSTRACT
BACKGROUND AND

PURPOSE:

Acute ischemic stroke and large vessel occlusion can be concurrent with the coronavirus disease 2019 (COVID-19) infection. Outcomes after mechanical thrombectomy (MT) for large vessel occlusion in patients with COVID-19 are substantially unknown. Our aim was to study early outcomes after MT in patients with COVID-19.

METHODS:

Multicenter, European, cohort study involving 34 stroke centers in France, Italy, Spain, and Belgium. Data were collected between March 1, 2020 and May 5, 2020. Consecutive laboratory-confirmed COVID-19 cases with large vessel occlusion, who were treated with MT, were included. Primary investigated

outcome:

30-day mortality. SECONDARY

OUTCOMES:

early neurological improvement (National Institutes of Health Stroke Scale improvement ≥8 points or 24 hours National Institutes of Health Stroke Scale 0-1), successful reperfusion (modified Thrombolysis in Cerebral Infarction grade ≥2b), and symptomatic intracranial hemorrhage.

RESULTS:

We evaluated 93 patients with COVID-19 with large vessel occlusion who underwent MT (median age, 71 years [interquartile range, 59-79]; 63 men [67.7%]). Median pretreatment National Institutes of Health Stroke Scale and Alberta Stroke Program Early CT Score were 17 (interquartile range, 11-21) and 8 (interquartile range, 7-9), respectively. Anterior circulation acute ischemic stroke represented 93.5% of cases. The rate modified Thrombolysis in Cerebral Infarction 2b to 3 was 79.6% (74 patients [95% CI, 71.3-87.8]). Thirty-day mortality was 29% (27 patients [95% CI, 20-39.4]). Early neurological improvement was 19.5% (17 patients [95% CI, 11.8-29.5]), and symptomatic intracranial hemorrhage was 5.4% (5 patients [95% CI, 1.7-12.1]). Patients who died at 30 days exhibited significantly lower lymphocyte count, higher levels of aspartate, and LDH (lactate dehydrogenase). After adjustment for age, initial National Institutes of Health Stroke Scale, Alberta Stroke Program Early CT Score, and successful reperfusion, these biological markers remained associated with increased odds of 30-day mortality (adjusted odds ratio of 2.70 [95% CI, 1.21-5.98] per SD-log decrease in lymphocyte count, 2.66 [95% CI, 1.22-5.77] per SD-log increase in aspartate, and 4.30 [95% CI, 1.43-12.91] per SD-log increase in LDH).

CONCLUSIONS:

The 29% rate of 30-day mortality after MT among patients with COVID-19 is not negligible. Abnormalities of lymphocyte count, LDH and aspartate may depict a patient's profiles with poorer outcomes after MT. Registration URL https//www.clinicaltrials.gov. Unique identifier NCT04406090.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombectomy / Endovascular Procedures / Ischemic Stroke / COVID-19 Type of study: Controlled clinical trial / Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Stroke Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombectomy / Endovascular Procedures / Ischemic Stroke / COVID-19 Type of study: Controlled clinical trial / Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Stroke Year: 2021 Document Type: Article