tetano
Editor, Senior Moderator
Stroke
. 2020 Dec 7;STROKEAHA120031668.
doi: 10.1161/STROKEAHA.120.031668. Online ahead of print.
Acute Cerebrovascular Events With COVID-19 Infection
Mandip S Dhamoon[SUP] 1 [/SUP], Alison Thaler[SUP] 1 [/SUP], Kapil Gururangan[SUP] 1 [/SUP], Amit Kohli[SUP] 1 [/SUP], Daniella Sisniega[SUP] 1 [/SUP], Danielle Wheelwright[SUP] 1 [/SUP], Connor Mensching[SUP] 1 [/SUP], Johanna T Fifi[SUP] 1 [/SUP], Michael G Fara[SUP] 1 [/SUP], Nathalie Jette[SUP] 1 [/SUP], Ella Cohen[SUP] 1 [/SUP], Priya Dave[SUP] 1 [/SUP], Aislyn C DiRisio[SUP] 1 [/SUP], Jonathan Goldstein, Emma M Loebel[SUP] 1 [/SUP], Naomi A Mayman[SUP] 1 [/SUP], Akarsh Sharma[SUP] 1 [/SUP], Daniel S Thomas[SUP] 1 [/SUP], Ruben D Vega Perez[SUP] 1 [/SUP], Mark R Weingarten[SUP] 1 [/SUP], Huei Hsun Wen[SUP] 1 [/SUP], Stanley Tuhrim[SUP] 1 [/SUP], Laura K Stein[SUP] 1 [/SUP], Mount Sinai Stroke Investigators
Collaborators, Affiliations
Abstract
Background and purpose: Coronavirus disease 2019 (COVID-19) has been associated with an increased incidence of thrombotic events, including stroke. However, characteristics and outcomes of COVID-19 patients with stroke are not well known.
Methods: We conducted a retrospective observational study of risk factors, stroke characteristics, and short-term outcomes in a large health system in New York City. We included consecutively admitted patients with acute cerebrovascular events from March 1, 2020 through April 30, 2020. Data were stratified by COVID-19 status, and demographic variables, medical comorbidities, stroke characteristics, imaging results, and in-hospital outcomes were examined. Among COVID-19-positive patients, we also summarized laboratory test results.
Results: Of 277 patients with stroke, 105 (38.0%) were COVID-19-positive. Compared with COVID-19-negative patients, COVID-19-positive patients were more likely to have a cryptogenic (51.8% versus 22.3%, P<0.0001) stroke cause and were more likely to suffer ischemic stroke in the temporal (P=0.02), parietal (P=0.002), occipital (P=0.002), and cerebellar (P=0.028) regions. In COVID-19-positive patients, mean coagulation markers were slightly elevated (prothrombin time 15.4?3.6 seconds, partial thromboplastin time 38.6?24.5 seconds, and international normalized ratio 1.4?1.3). Outcomes were worse among COVID-19-positive patients, including longer length of stay (P<0.0001), greater percentage requiring intensive care unit care (P=0.017), and greater rate of neurological worsening during admission (P<0.0001); additionally, more COVID-19-positive patients suffered in-hospital death (33% versus 12.9%, P<0.0001).
Conclusions: Baseline characteristics in patients with stroke were similar comparing those with and without COVID-19. However, COVID-19-positive patients were more likely to experience stroke in a lobar location, more commonly had a cryptogenic cause, and had worse outcomes.
Keywords: epidemiology; incidence; intracerebral hemorrhage; ischemic stroke; length of stay; risk factors; subarachnoid hemorrhage.
. 2020 Dec 7;STROKEAHA120031668.
doi: 10.1161/STROKEAHA.120.031668. Online ahead of print.
Acute Cerebrovascular Events With COVID-19 Infection
Mandip S Dhamoon[SUP] 1 [/SUP], Alison Thaler[SUP] 1 [/SUP], Kapil Gururangan[SUP] 1 [/SUP], Amit Kohli[SUP] 1 [/SUP], Daniella Sisniega[SUP] 1 [/SUP], Danielle Wheelwright[SUP] 1 [/SUP], Connor Mensching[SUP] 1 [/SUP], Johanna T Fifi[SUP] 1 [/SUP], Michael G Fara[SUP] 1 [/SUP], Nathalie Jette[SUP] 1 [/SUP], Ella Cohen[SUP] 1 [/SUP], Priya Dave[SUP] 1 [/SUP], Aislyn C DiRisio[SUP] 1 [/SUP], Jonathan Goldstein, Emma M Loebel[SUP] 1 [/SUP], Naomi A Mayman[SUP] 1 [/SUP], Akarsh Sharma[SUP] 1 [/SUP], Daniel S Thomas[SUP] 1 [/SUP], Ruben D Vega Perez[SUP] 1 [/SUP], Mark R Weingarten[SUP] 1 [/SUP], Huei Hsun Wen[SUP] 1 [/SUP], Stanley Tuhrim[SUP] 1 [/SUP], Laura K Stein[SUP] 1 [/SUP], Mount Sinai Stroke Investigators
Collaborators, Affiliations
- PMID: 33280551
- DOI: 10.1161/STROKEAHA.120.031668
Abstract
Background and purpose: Coronavirus disease 2019 (COVID-19) has been associated with an increased incidence of thrombotic events, including stroke. However, characteristics and outcomes of COVID-19 patients with stroke are not well known.
Methods: We conducted a retrospective observational study of risk factors, stroke characteristics, and short-term outcomes in a large health system in New York City. We included consecutively admitted patients with acute cerebrovascular events from March 1, 2020 through April 30, 2020. Data were stratified by COVID-19 status, and demographic variables, medical comorbidities, stroke characteristics, imaging results, and in-hospital outcomes were examined. Among COVID-19-positive patients, we also summarized laboratory test results.
Results: Of 277 patients with stroke, 105 (38.0%) were COVID-19-positive. Compared with COVID-19-negative patients, COVID-19-positive patients were more likely to have a cryptogenic (51.8% versus 22.3%, P<0.0001) stroke cause and were more likely to suffer ischemic stroke in the temporal (P=0.02), parietal (P=0.002), occipital (P=0.002), and cerebellar (P=0.028) regions. In COVID-19-positive patients, mean coagulation markers were slightly elevated (prothrombin time 15.4?3.6 seconds, partial thromboplastin time 38.6?24.5 seconds, and international normalized ratio 1.4?1.3). Outcomes were worse among COVID-19-positive patients, including longer length of stay (P<0.0001), greater percentage requiring intensive care unit care (P=0.017), and greater rate of neurological worsening during admission (P<0.0001); additionally, more COVID-19-positive patients suffered in-hospital death (33% versus 12.9%, P<0.0001).
Conclusions: Baseline characteristics in patients with stroke were similar comparing those with and without COVID-19. However, COVID-19-positive patients were more likely to experience stroke in a lobar location, more commonly had a cryptogenic cause, and had worse outcomes.
Keywords: epidemiology; incidence; intracerebral hemorrhage; ischemic stroke; length of stay; risk factors; subarachnoid hemorrhage.