tetano
Editor, Senior Moderator
BMC Neurol
. 2021 Jan 30;21(1):43.
doi: 10.1186/s12883-021-02075-1.
Stroke etiologies in patients with COVID-19: the SVIN COVID-19 multinational registry
Mar?a E Ramos-Araque[SUP] 1 2 [/SUP], James E Siegler[SUP] 3 [/SUP], Marc Ribo[SUP] 4 5 [/SUP], Manuel Requena[SUP] 4 5 [/SUP], Cristina L?pez[SUP] 2 [/SUP], Mercedes de Lera[SUP] 2 [/SUP], Juan F Arenillas[SUP] 2 [/SUP], Isabel Hern?ndez P?rez[SUP] 2 [/SUP], Beatriz G?mez-Vicente[SUP] 2 [/SUP], Blanca Talavera[SUP] 2 [/SUP], Pere Cardona Portela[SUP] 6 [/SUP], Ana Nu?ez Guillen[SUP] 6 [/SUP], Xabier Urra[SUP] 7 [/SUP], Laura Llull[SUP] 7 [/SUP], Arturo Ren?[SUP] 7 [/SUP], Thanh N Nguyen[SUP] 8 [/SUP], Dinesh Jillella[SUP] 9 [/SUP], Fadi Nahab[SUP] 9 [/SUP], Raul Nogueira[SUP] 10 [/SUP], Diogo Haussen[SUP] 10 [/SUP], Ryna Then[SUP] 11 [/SUP], Jesse M Thon[SUP] 11 [/SUP], Luis Rodr?guez Esparragoza[SUP] 12 [/SUP], Maria Hern?ndez-P?rez[SUP] 12 [/SUP], Alejandro Bustamante[SUP] 12 [/SUP], Ossama Yassin Mansour[SUP] 13 [/SUP], Mohammed Megahed[SUP] 14 [/SUP], Tamer Hassan[SUP] 15 [/SUP], David S Liebeskind[SUP] 16 [/SUP], Ameer Hassan[SUP] 17 18 [/SUP], Saif Bushnaq[SUP] 19 [/SUP], Mohamed Osman[SUP] 19 [/SUP], Alejandro Rodriguez Vazquez[SUP] 7 [/SUP], SVIN Multinational Registry and Task Force
Collaborators, Affiliations
Abstract
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.
Keywords: COVID-19; Coronavirus; Cryptogenic; Mortality; Stroke.
. 2021 Jan 30;21(1):43.
doi: 10.1186/s12883-021-02075-1.
Stroke etiologies in patients with COVID-19: the SVIN COVID-19 multinational registry
Mar?a E Ramos-Araque[SUP] 1 2 [/SUP], James E Siegler[SUP] 3 [/SUP], Marc Ribo[SUP] 4 5 [/SUP], Manuel Requena[SUP] 4 5 [/SUP], Cristina L?pez[SUP] 2 [/SUP], Mercedes de Lera[SUP] 2 [/SUP], Juan F Arenillas[SUP] 2 [/SUP], Isabel Hern?ndez P?rez[SUP] 2 [/SUP], Beatriz G?mez-Vicente[SUP] 2 [/SUP], Blanca Talavera[SUP] 2 [/SUP], Pere Cardona Portela[SUP] 6 [/SUP], Ana Nu?ez Guillen[SUP] 6 [/SUP], Xabier Urra[SUP] 7 [/SUP], Laura Llull[SUP] 7 [/SUP], Arturo Ren?[SUP] 7 [/SUP], Thanh N Nguyen[SUP] 8 [/SUP], Dinesh Jillella[SUP] 9 [/SUP], Fadi Nahab[SUP] 9 [/SUP], Raul Nogueira[SUP] 10 [/SUP], Diogo Haussen[SUP] 10 [/SUP], Ryna Then[SUP] 11 [/SUP], Jesse M Thon[SUP] 11 [/SUP], Luis Rodr?guez Esparragoza[SUP] 12 [/SUP], Maria Hern?ndez-P?rez[SUP] 12 [/SUP], Alejandro Bustamante[SUP] 12 [/SUP], Ossama Yassin Mansour[SUP] 13 [/SUP], Mohammed Megahed[SUP] 14 [/SUP], Tamer Hassan[SUP] 15 [/SUP], David S Liebeskind[SUP] 16 [/SUP], Ameer Hassan[SUP] 17 18 [/SUP], Saif Bushnaq[SUP] 19 [/SUP], Mohamed Osman[SUP] 19 [/SUP], Alejandro Rodriguez Vazquez[SUP] 7 [/SUP], SVIN Multinational Registry and Task Force
Collaborators, Affiliations
- PMID: 33514335
- DOI: 10.1186/s12883-021-02075-1
Abstract
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.
Keywords: COVID-19; Coronavirus; Cryptogenic; Mortality; Stroke.