Timing of Acute Stroke in COVID-19-A Health System Registry Study.

Autor:	Migdady I; Department of Neurology, Cleveland Clinic, Cleveland, OH, USA.; Division of Neurocritical Care, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Shoskes A; Department of Neurology, Cleveland Clinic, Cleveland, OH, USA., Hasan LZ; Department of Medicine, University of Connecticut, Farmington, CT, USA.; Department of Infectious Diseases, Cleveland Clinic, Cleveland, OH, USA., Hassett C; Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA., George P; Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA., Newey C; Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA., Cho SM; Departments of Neurology, Neurological Intensive Care, Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Rae-Grant A; Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA., Uchino K; Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
Jazyk:	angličtina
Zdroj:	The Neurohospitalist [Neurohospitalist] 2021 Oct; Vol. 11 (4), pp. 285-294. Date of Electronic Publication: 2021 Jan 08.
DOI:	10.1177/1941874420985983
Abstrakt:	Background and Purpose: The association between SARS-CoV-2 infection and stroke remains unknown. We aimed to compare the characteristics of stroke patients who were hospitalized with Coronavirus Disease 2019 (COVID-19) based on the timing of stroke diagnosis. Methods: We performed a retrospective analysis of adult patients in a health system registry of COVID-19 who were hospitalized and had imaging-confirmed acute stroke during hospitalization. Baseline characteristics and hospital outcomes were collected and analyzed. Results: Out of 882 COVID-19 patients who were hospitalized between March 9 to May 17, 2020, 14 patients (2% of all COVID-19 patients and 21% of those who underwent imaging) presented with stroke or developed stroke during hospitalization. Eleven had acute ischemic stroke (AIS) and 3 had acute hemorrhagic stroke. Six patients (43%) presented to the hospital with acute stroke symptoms and were found to have SARS-CoV-2. Compared to patients who presented with AIS, more patients with AIS during hospitalization were male, of older age, had pneumonia and acute respiratory distress syndrome, were severely ill, and had high inflammatory and thrombotic markers (including C reactive protein, D dimer, ferritin, and fibrinogen). Among all patients, hospital mortality was high (50%) and the majority of patients who were discharged had poor neurological outcome. Conclusions: A distinction should be made between patients who present with acute stroke with concurrent SARS-CoV-2 infection and those who develop stroke as a complication of severe COVID-19. It is likely that a subset of stroke patients will incidentally test positive for the virus given the widespread pandemic. Competing Interests: Declaration of Conflicting Interests: Ken Uchino has received compensation from Ono Pharmaceutical Co, Lt., Portola, Inc., Abbott Laboratories, and Genentech, Inc., unrelated to this work. (© The Author(s) 2021.)
Databáze:	MEDLINE
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