tetano
Editor, Senior Moderator
Ann Indian Acad Neurol
. Sep-Oct 2021;24(5):668-685.
doi: 10.4103/aian.AIAN_122_21. Epub 2021 Aug 30.
Clinical Features and Outcome of Stroke with COVID-19. COVID-19 Stroke Study Group (CSSG), India
Rohit Bhatia[SUP] 1 [/SUP], M V Padma Srivastava[SUP] 1 [/SUP], P N Sylaja[SUP] 2 [/SUP], Snigdha Komakula[SUP] 1 [/SUP], Ashish Upadhyay[SUP] 3 [/SUP], Vibhor Pardasani[SUP] 4 [/SUP], Thomas Iype[SUP] 5 [/SUP], Rajsrinivas Parthasarathy[SUP] 6 7 [/SUP], Rajshekhar Reddy[SUP] 5 [/SUP], Suman Kushwaha[SUP] 8 [/SUP], Jayanta Roy[SUP] 9 [/SUP], P Satish[SUP] 1 [/SUP], Anjan Trikha[SUP] 10 [/SUP], Naveet Wig[SUP] 11 [/SUP], Lalit Dhar[SUP] 12 [/SUP], Deepti Vibha[SUP] 1 [/SUP], Venugopalan Y Vishnu[SUP] 1 [/SUP], Awadh Kishore Pandit[SUP] 1 [/SUP], Anu Gupta[SUP] 1 [/SUP], A Elavarasi[SUP] 1 [/SUP], Ayush Agarwal[SUP] 1 [/SUP], Vipul Gupta[SUP] 7 [/SUP], Rakesh K Singh[SUP] 4 [/SUP], Harsh Oza[SUP] 4 [/SUP], Hiral Halani[SUP] 4 [/SUP], Dileep Ramachandran[SUP] 5 [/SUP], Githin B George[SUP] 5 [/SUP], Praveen Panicker[SUP] 5 [/SUP], M K Suresh[SUP] 12 [/SUP], S Kumaravelu[SUP] 13 [/SUP], Dheeraj Khurana[SUP] 14 [/SUP], Srijithesh P Rajendran[SUP] 15 [/SUP], Vijaya Pamidimukkala[SUP] 16 [/SUP], Salil Gupta[SUP] 17 [/SUP], Jeyaraj D Pandian[SUP] 18 [/SUP], Debashish Chowdhury[SUP] 19 [/SUP], Nirendra K Rai[SUP] 20 [/SUP], Arvind Sharma[SUP] 21 [/SUP], Vivek K Nambiar[SUP] 22 [/SUP]
Affiliations
Abstract
Background and purpose: Occurrence of stroke has been reported among patients with COVID-19. The present study compares clinical features and outcomes of stroke patients with and without COVID-19.
Methods: The COVID-19 Stroke Study Group (CSSG) is a multicentric study in 18 sites across India to observe and compare the clinical characteristics of patients with stroke admitted during the current pandemic period and a similar epoch in 2019. The present study reports patients of stroke with and without COVID-19 (CoVS and non-CoVS, respectively) seen between February 2020 and July 2020. Demographic, clinical, treatment, and outcome details of patients were collected.
Results: The mean age and gender were comparable between the two groups. CoVS patients had higher stroke severity and extent of cerebral involvement on imaging. In-hospital complications and death were higher among CoVS patients (53.06% vs. 17.51%; P < 0.001) and (42.31% vs. 7.6%; P < 0.001), respectively. At 3 months, higher mortality was observed among CoVS patients (67.65% vs. 13.43%; P < 0.001) and good outcome (modified Rankin score [mRS]: 0-2) was seen more often in non-CoVS patients (68.86% vs. 33.33%; P < 0.001). The presence of COVID-19 and baseline stroke severity were independent predictors of mortality.
Conclusions: CoVS is associated with higher severity, poor outcome, and increased mortality. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and baseline stroke severity are independent predictors of mortality.
Keywords: COVID-19; SARS-CoV-2; ischemic stroke; stroke; thrombolysis.
. Sep-Oct 2021;24(5):668-685.
doi: 10.4103/aian.AIAN_122_21. Epub 2021 Aug 30.
Clinical Features and Outcome of Stroke with COVID-19. COVID-19 Stroke Study Group (CSSG), India
Rohit Bhatia[SUP] 1 [/SUP], M V Padma Srivastava[SUP] 1 [/SUP], P N Sylaja[SUP] 2 [/SUP], Snigdha Komakula[SUP] 1 [/SUP], Ashish Upadhyay[SUP] 3 [/SUP], Vibhor Pardasani[SUP] 4 [/SUP], Thomas Iype[SUP] 5 [/SUP], Rajsrinivas Parthasarathy[SUP] 6 7 [/SUP], Rajshekhar Reddy[SUP] 5 [/SUP], Suman Kushwaha[SUP] 8 [/SUP], Jayanta Roy[SUP] 9 [/SUP], P Satish[SUP] 1 [/SUP], Anjan Trikha[SUP] 10 [/SUP], Naveet Wig[SUP] 11 [/SUP], Lalit Dhar[SUP] 12 [/SUP], Deepti Vibha[SUP] 1 [/SUP], Venugopalan Y Vishnu[SUP] 1 [/SUP], Awadh Kishore Pandit[SUP] 1 [/SUP], Anu Gupta[SUP] 1 [/SUP], A Elavarasi[SUP] 1 [/SUP], Ayush Agarwal[SUP] 1 [/SUP], Vipul Gupta[SUP] 7 [/SUP], Rakesh K Singh[SUP] 4 [/SUP], Harsh Oza[SUP] 4 [/SUP], Hiral Halani[SUP] 4 [/SUP], Dileep Ramachandran[SUP] 5 [/SUP], Githin B George[SUP] 5 [/SUP], Praveen Panicker[SUP] 5 [/SUP], M K Suresh[SUP] 12 [/SUP], S Kumaravelu[SUP] 13 [/SUP], Dheeraj Khurana[SUP] 14 [/SUP], Srijithesh P Rajendran[SUP] 15 [/SUP], Vijaya Pamidimukkala[SUP] 16 [/SUP], Salil Gupta[SUP] 17 [/SUP], Jeyaraj D Pandian[SUP] 18 [/SUP], Debashish Chowdhury[SUP] 19 [/SUP], Nirendra K Rai[SUP] 20 [/SUP], Arvind Sharma[SUP] 21 [/SUP], Vivek K Nambiar[SUP] 22 [/SUP]
Affiliations
- PMID: 35002124
- PMCID: PMC8680894
- DOI: 10.4103/aian.AIAN_122_21
Abstract
Background and purpose: Occurrence of stroke has been reported among patients with COVID-19. The present study compares clinical features and outcomes of stroke patients with and without COVID-19.
Methods: The COVID-19 Stroke Study Group (CSSG) is a multicentric study in 18 sites across India to observe and compare the clinical characteristics of patients with stroke admitted during the current pandemic period and a similar epoch in 2019. The present study reports patients of stroke with and without COVID-19 (CoVS and non-CoVS, respectively) seen between February 2020 and July 2020. Demographic, clinical, treatment, and outcome details of patients were collected.
Results: The mean age and gender were comparable between the two groups. CoVS patients had higher stroke severity and extent of cerebral involvement on imaging. In-hospital complications and death were higher among CoVS patients (53.06% vs. 17.51%; P < 0.001) and (42.31% vs. 7.6%; P < 0.001), respectively. At 3 months, higher mortality was observed among CoVS patients (67.65% vs. 13.43%; P < 0.001) and good outcome (modified Rankin score [mRS]: 0-2) was seen more often in non-CoVS patients (68.86% vs. 33.33%; P < 0.001). The presence of COVID-19 and baseline stroke severity were independent predictors of mortality.
Conclusions: CoVS is associated with higher severity, poor outcome, and increased mortality. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and baseline stroke severity are independent predictors of mortality.
Keywords: COVID-19; SARS-CoV-2; ischemic stroke; stroke; thrombolysis.