Acute ischemic stroke outcomes in patients with COVID-19: a systematic review and meta-analysis.

Autor:	Ferrone SR; Institute for Health System Science, Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USA., Sanmartin MX; Institute for Health System Science, Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USA.; Department of Radiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA., Ohara J; Department of Radiology, Northwell Health, Manhasset, NY, USA., Jimenez JC; Department of Radiology, Northwell Health, Manhasset, NY, USA., Feizullayeva C; Department of Radiology, Northwell Health, Manhasset, NY, USA., Lodato Z; Institute for Health System Science, Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USA., Shahsavarani S; Institute for Health System Science, Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USA., Lacher G; Institute for Health System Science, Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USA., Demissie S; Department of Biostatistics, Northwell Health Feinstein Institutes for Medical Research, Manhasset, NY, USA., Vialet JM; Medical Library Services, Northwell Health, Manhasset, NY, USA., White TG; Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA., Wang JJ; Institute for Health System Science, Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USA.; Department of Radiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA., Katz JM; Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA., Sanelli PC; Institute for Health System Science, Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USA psanelli@northwell.edu.; Department of Radiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA.; Department of Radiology, Northwell Health, Manhasset, NY, USA.
Jazyk:	angličtina
Zdroj:	Journal of neurointerventional surgery [J Neurointerv Surg] 2024 Mar 14; Vol. 16 (4), pp. 333-341. Date of Electronic Publication: 2024 Mar 14.
DOI:	10.1136/jnis-2023-020489
Abstrakt:	Background: Although patients with COVID-19 have a higher risk of acute ischemic stroke (AIS), the impact on stroke outcomes remains uncertain. Aims: To determine the clinical outcomes of patients with AIS and COVID-19 (AIS-COVID+). Methods: We performed a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Our protocol was registered with the International Prospective Register of Systematic Reviews (CRD42020211977). Systematic searches were last performed on June 3, 2021 in EMBASE, PubMed, Web-of-Science, Scopus, and CINAHL Databases. Inclusion Criteria: (1) studies reporting outcomes on AIS-COVID+; (2) original articles published in 2020 or later; (3) study participants aged ≥18 years. Exclusion Criteria: (1) case reports with <5 patients, abstracts, review articles; (2) studies analyzing novel interventions. Risk of bias was assessed using the Mixed Methods Appraisal Tool. Random-effects models estimated the pooled OR and 95% confidence intervals (95% CI) for mortality, modified Rankin Scale (mRS) score, length of stay (LOS), and discharge disposition. Results: Of the 43 selected studies, 46.5% (20/43) reported patients with AIS without COVID-19 (AIS-COVID-) for comparison. Random-effects model included 7294 AIS-COVID+ and 158 401 AIS-COVID-. Compared with AIS-COVID-, AIS-COVID+ patients had higher in-hospital mortality (OR=3.87 (95% CI 2.75 to 5.45), P<0.001), less mRS scores 0-2 (OR=0.53 (95% CI 0.46 to 0.62), P<0.001), longer LOS (mean difference=4.21 days (95% CI 1.96 to 6.47), P<0.001), and less home discharge (OR=0.31 (95% CI 0.21 to 0.47), P<0.001). Conclusions: Patients with AIS-COVID had worse outcomes, with almost fourfold increased mortality, half the odds of mRS scores 0-2, and one-third the odds of home discharge. These findings confirm the significant impact of COVID-19 on early stroke outcomes. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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