Impact of COVID-19 Infection on the Outcome of Patients With Ischemic Stroke
Por:
Marti-Fabregas, J, Guisado-Alonso, D, Delgado-Mederos, R, Martinez-Domeno, A, Prats-Sanchez, L, Guasch-Jimenez, M, Cardona, P, Nunez-Guillen, A, Requena, M, Rubiera, M, Olive, M, Bustamante, A, Gomis, M, Amaro, S, Llull, L, Ustrell, X, de Oliveira, GC, Sero, L, Gomez-Choco, M, Mena, L, Serena, J, Viturro, SB, Purroy, F, Vicente, M, Rodriguez-Campello, A, Ois, A, Catena, E, Garcia-Carreira, MC, Barrachina, O, Palomeras, E, Krupinski, J, Almeria, M, Zaragoza, J, Esteve, P, Cocho, D, Moreira, A, van Eendenburg, C, Codas, JE, de la Ossa, NP, Salvat, M and Camps-Renom, P
Publicada:
1 dic 2021
Ahead of Print:
30 ago 2021
Resumen:
Background and Purpose: We evaluated whether stroke severity, functional outcome, and mortality are different in patients with ischemic stroke with or without coronavirus disease 2019 (COVID-19) infection. Methods: A prospective, observational, multicentre cohort study in Catalonia, Spain. Recruitment was consecutive from mid-March to mid-May 2020. Patients had an acute ischemic stroke within 48 hours and a previous modified Rankin Scale (mRS) score of 0 to 3. We collected demographic data, vascular risk factors, prior mRS score, National Institutes of Health Stroke Scale score, rate of reperfusion therapies, logistics, and metrics. Primary end point was functional outcome at 3 months. Favourable outcome was defined depending on the previous mRS score. Secondary outcome was mortality at 3 months. We performed mRS shift and multivariable analyses. Results: We evaluated 701 patients (mean age 72.3 +/- 13.3 years, 60.5% men) and 91 (13%) had COVID-19 infection. Median baseline National Institutes of Health Stroke Scale score was higher in patients with COVID-19 compared with patients without COVID-19 (8 [3-18] versus 6 [2-14], P=0.049). Proportion of patients with a favourable functional outcome was 33.7% in the COVID-19 and 47% in the non-COVID-19 group. However, after a multivariable logistic regression analysis, COVID-19 infection did not increase the probability of unfavourable functional outcome. Mortality rate was 39.3% among patients with COVID-19 and 16.1% in the non-COVID-19 group. In the multivariable logistic regression analysis, COVID-19 infection was a risk factor for mortality (hazard ratio, 3.14 [95% CI, 2.10-4.71]; P<0.001). Conclusions: Patients with ischemic stroke and COVID-19 infection have more severe strokes and a higher mortality than patients with stroke without COVID-19 infection. However, functional outcome is comparable in both groups.
Filiaciones:
Marti-Fabregas, J:
Hosp Santa Creu & Sant Pau, Dept Neurol, Avda St Antoni Maria Claret 167, Barcelona 08025, Spain
Guisado-Alonso, D:
Hosp Santa Creu & Sant Pau, Dept Neurol, Avda St Antoni Maria Claret 167, Barcelona 08025, Spain
Delgado-Mederos, R:
Hosp Santa Creu & Sant Pau, Dept Neurol, Avda St Antoni Maria Claret 167, Barcelona 08025, Spain
Martinez-Domeno, A:
Hosp Santa Creu & Sant Pau, Dept Neurol, Avda St Antoni Maria Claret 167, Barcelona 08025, Spain
Prats-Sanchez, L:
Hosp Santa Creu & Sant Pau, Dept Neurol, Avda St Antoni Maria Claret 167, Barcelona 08025, Spain
Guasch-Jimenez, M:
Hosp Santa Creu & Sant Pau, Dept Neurol, Avda St Antoni Maria Claret 167, Barcelona 08025, Spain
Cardona, P:
Hosp Univ Bellvitge, Dept Neurol, Lhospitalet De Llobregat, Spain
Nunez-Guillen, A:
Hosp Univ Bellvitge, Dept Neurol, Lhospitalet De Llobregat, Spain
Requena, M:
Hosp Univ Vall dHebron, Dept Neurol, Barcelona, Spain
Rubiera, M:
Hosp Univ Vall dHebron, Dept Neurol, Barcelona, Spain
Olive, M:
Hosp Univ Vall dHebron, Dept Neurol, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, Dept Neurol, Badalona, Spain
:
Hosp Badalona Germans Trias & Pujol, Dept Neurol, Badalona, Spain
Amaro, S:
Hosp Univ Clin, Dept Neurol, Barcelona, Spain
Llull, L:
Hosp Univ Clin, Dept Neurol, Barcelona, Spain
Ustrell, X:
Hosp Univ Joan XXIII, Dept Neurol, Tarragona, Spain
de Oliveira, GC:
Hosp Univ Joan XXIII, Dept Neurol, Tarragona, Spain
Sero, L:
Hosp Univ Joan XXIII, Dept Neurol, Tarragona, Spain
Gomez-Choco, M:
Hosp St Joan Despi Moises Broggi, Dept Neurol, Sant Joan Despi, Spain
Mena, L:
Hosp St Joan Despi Moises Broggi, Dept Neurol, Sant Joan Despi, Spain
Serena, J:
Hosp Univ Dr Josep Trueta, Dept Neurol, Girona, Spain
Viturro, SB:
Hosp Univ Dr Josep Trueta, Dept Neurol, Girona, Spain
Purroy, F:
Hosp Arnau Vilanova, Stroke Unit, Lleida, Spain
Vicente, M:
Hosp Arnau Vilanova, Stroke Unit, Lleida, Spain
Rodriguez-Campello, A:
Hosp Mar, Dept Neurol, Barcelona, Spain
Ois, A:
Hosp Mar, Dept Neurol, Barcelona, Spain
Catena, E:
Hosp Comarcal Alt Penedes, Dept Neurol, Vilafranca Del Penedes, Spain
Garcia-Carreira, MC:
Hosp Univ Parc Tauli, Dept Neurol, Sabadell, Spain
Barrachina, O:
Hosp Univ Parc Tauli, Dept Neurol, Sabadell, Spain
Palomeras, E:
Hosp Mataro, Dept Neurol, Mataro, Spain
Krupinski, J:
Hosp Univ Mutua Terrassa, Dept Neurol, Barcelona, Spain
Almeria, M:
Hosp Univ Mutua Terrassa, Dept Neurol, Barcelona, Spain
Zaragoza, J:
Hosp Tortosa Verge de la Cinta, Dept Neurol, Tarragona, Spain
Esteve, P:
Hosp Tortosa Verge de la Cinta, Dept Neurol, Tarragona, Spain
Cocho, D:
Hosp Gen Granollers, Dept Neurol, Barcelona, Spain
Moreira, A:
Hosp Mar, Dept Neurol, Barcelona, Spain
Hosp dIgualada, Dept Neurol, Barcelona, Spain
van Eendenburg, C:
Hosp Figueres, Dept Neurol, Girona, Spain
Codas, JE:
Consorci Sanitari Terrassa, Dept Neurol, Barcelona, Spain
de la Ossa, NP:
Agcy Hlth Qual & Assessment Catalonia, Stroke Program, Barcelona, Spain
Salvat, M:
Agcy Hlth Qual & Assessment Catalonia, Stroke Program, Barcelona, Spain
Camps-Renom, P:
Hosp Santa Creu & Sant Pau, Dept Neurol, Avda St Antoni Maria Claret 167, Barcelona 08025, Spain
Green Published, Bronze
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