Ischemic stroke in COVID-19 patients: mechanisms, treatment and outcomes in a consecutive Swiss Stroke Registry analysis.

Strambo, Davide; De Marchis, Gian Marco; Bonati, Leo H; Arnold, Marcel; Carrera, Emmanuel; Galletta, Santi; Nedeltchev, Krassen; Kahles, Timo; Cereda, Carlo W; Bianco, Giovanni; Kägi, Georg; Luft, Andreas R; Bolognese, Manuel; Lakatos, Lehel-Barna; Salmen, Stephan; Correia, Pamela; Sturzenegger, Rolf; Sylvan, Albert; Medlin, Friedrich; Berger, Christian; ... (2022). Ischemic stroke in COVID-19 patients: mechanisms, treatment and outcomes in a consecutive Swiss Stroke Registry analysis. European journal of neurology, 29(3), pp. 732-743. Blackwell Science 10.1111/ene.15199

Preview

Text Strambo__2021__Ischemic_stroke_in_COVID_19_patients_Mechanisms_treatment_and_outcomes.pdf - Published Version Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND). Download (458kB) | Preview

BACKGROUND

Most case series of patients with ischemic stroke (IS) and COVID-19 are limited to selected centers or lack 3-month outcome. Aim of this study is to describe frequency, clinical and radiological features, and 3-month outcomes of patients with IS and COVID-19 in a nationwide stroke registry.

METHODS

From the Swiss Stroke Registry (SSR), we included all consecutive IS patients ≥18 years admitted to Swiss Stroke Centers or Stroke Units during the first wave of COVID-19 (25/02 to 08/06/2020). We compared baseline features, etiology and 3-month outcome of SARS-CoV-2 PCR+ IS patients to SARS-CoV-2 PCR- and/or asymptomatic non-tested IS patients.

RESULTS

Of the 2341 IS patients registered in the SSR during the study period, 36 (1.5%) had confirmed COVID-19 infection, of whom 33 within one month before or after stroke onset. In multivariate analysis, COVID+ patients had more lesions in multiple vascular territories (OR=2.35, 95%CI=1.08-5.14, p=0.032) and less cryptogenic strokes (OR=0.37, 95%CI=0.14-0.99, p=0.049). COVID-19 was judged the likely principal cause of stroke in 8 patients (24%), a contributing/triggering factor in 12(36%) and likely not contributing to stroke in 13(40%). There was a strong trend towards worse functional outcome in COVID+ patients after propensity score (PS) adjustment for age, stroke severity and revascularization treatments (PS-adjusted common OR for shift towards higher mRS=1.85, 95%CI 0.96-3.58, p=0.07).

CONCLUSION

In this nationwide analysis of consecutive ischemic strokes, concomitant COVID-19 was relatively rare. COVID+ patients more often had multi-territory stroke and less often cryptogenic stroke, and their 3-month functional outcome tended to be worse.

Interest & Impact

Downloads

271 since deposited on 21 Dec 2021
23 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item