Acute Cerebrovascular Events With COVID-19 Infection.

Autor:	Dhamoon MS; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Thaler A; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Gururangan K; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Kohli A; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Sisniega D; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Wheelwright D; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Mensching C; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Fifi JT; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Fara MG; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Jette N; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Cohen E; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Dave P; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., DiRisio AC; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Goldstein J; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Loebel EM; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Mayman NA; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Sharma A; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Thomas DS; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Vega Perez RD; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Weingarten MR; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Wen HH; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Tuhrim S; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York., Stein LK; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York.
Jazyk:	angličtina
Zdroj:	Stroke [Stroke] 2021 Jan; Vol. 52 (1), pp. 48-56. Date of Electronic Publication: 2020 Dec 07.
DOI:	10.1161/STROKEAHA.120.031668
Abstrakt:	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.
Databáze:	MEDLINE
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