Sistema de Salut de Catalunya
Institut Català de la Salut
[Ramos-Araque ME] Institute of Biomedical Research of Salamanca, Department of Neurology, Hospital Universitario de Salamanca, Salamanca, Spain. Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain. [Siegler JE] Cooper Neurologic Institute, Cooper University Hospital, Camden, NJ, USA. [Ribo M, Requena M] Unitat d’Ictus, Servei de Neurologia, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. [López C, de Lera M] Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
Vall d'Hebron Barcelona Hospital Campus
2021-06-11T06:36:54Z
2021-06-11T06:36:54Z
2021-01-30
Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Ictus; Mortalitat
Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Ictus; Mortalidad
Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Stroke; Mortality
Background and purpose Coronavirus disease 2019 (COVID-19) is associated with a small but clinically significant risk of stroke, the cause of which is frequently cryptogenic. In a large multinational cohort of consecutive COVID-19 patients with stroke, we evaluated clinical predictors of cryptogenic stroke, short-term functional outcomes and in-hospital mortality among patients according to stroke etiology. Methods We explored clinical characteristics and short-term outcomes of consecutively evaluated patients 18 years of age or older with acute ischemic stroke (AIS) and laboratory-confirmed COVID-19 from 31 hospitals in 4 countries (3/1/20–6/16/20). Results Of the 14.483 laboratory-confirmed patients with COVID-19, 156 (1.1%) were diagnosed with AIS. Sixty-one (39.4%) were female, 84 (67.2%) white, and 88 (61.5%) were between 60 and 79 years of age. The most frequently reported etiology of AIS was cryptogenic (55/129, 42.6%), which was associated with significantly higher white blood cell count, c-reactive protein, and D-dimer levels than non-cryptogenic AIS patients (p</=0.05 for all comparisons). In a multivariable backward stepwise regression model estimating the odds of in-hospital mortality, cryptogenic stroke mechanism was associated with a fivefold greater odds in-hospital mortality than strokes due to any other mechanism (adjusted OR 5.16, 95%CI 1.41–18.87, p = 0.01). In that model, older age (aOR 2.05 per decade, 95%CI 1.35–3.11, p < 0.01) and higher baseline NIHSS (aOR 1.12, 95%CI 1.02–1.21, p = 0.01) were also independently predictive of mortality. Conclusions Our findings suggest that cryptogenic stroke among COVID-19 patients carries a significant risk of early mortality.
MER-A was funded by The Instituto de Salud Carlos III (JR19/00020), Spain.
Article
Published version
English
Isquèmia cerebral - Mortalitat; Malalties - Factors de risc; COVID-19 (Malaltia); DISEASES::Cardiovascular Diseases::Vascular Diseases::Cerebrovascular Disorders::Brain Ischemia; Other subheadings::Other subheadings::Other subheadings::Other subheadings::/mortality; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors; DISEASES::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections; ENFERMEDADES::enfermedades cardiovasculares::enfermedades vasculares::trastornos cerebrovasculares::isquemia cerebral; Otros calificadores::Otros calificadores::Otros calificadores::Otros calificadores::/mortalidad; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::métodos epidemiológicos::estadística como asunto::probabilidad::riesgo::factores de riesgo; ENFERMEDADES::virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus
BMC
BMC Neurology;21
https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-021-02075-1
info:eu-repo/grantAgreement/ES/PE2017-2020/JR19%2F00020
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
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