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

[img]
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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Arnold, Marcel; Nedeltchev, Krassen; Mono, Marie-Luise; Beyeler, Morin and Fischer, Urs

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1351-5101

Publisher:

Blackwell Science

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

21 Dec 2021 16:17

Last Modified:

12 Feb 2022 00:12

Publisher DOI:

10.1111/ene.15199

PubMed ID:

34845794

Uncontrolled Keywords:

COVID-19 SARS-CoV-2 ischemic stroke

BORIS DOI:

10.48350/162284

URI:

https://boris.unibe.ch/id/eprint/162284

Actions (login required)

Edit item Edit item
Provide Feedback