Sex differences in ischemic stroke during COVID-19 first outbreak in northern Italy.

Autor: Sangalli D; Neurological Department, 'Alessandro Manzoni' Hospital, ASST, Lecco, Via dell'Eremo 9/11, 23900 Lecco, Italy. Electronic address: d.sangalli@asst-lecco.it., Versino M; Neurology and Stroke Unit, ASST SetteLaghi, Ospedale di Circolo, Varese, Italy; DMC, University of Insubria, Varese, Italy., Colombo I; Neurology and Stroke Unit, Ospedale di Desio, ASST, Monza, MB, Italy., Ciccone A; Department of Neurosciences, Carlo Poma Hospital, ASST di Mantova, Mantua, Italy., Beretta S; Department of Neurology, San Gerardo Hospital, ASST Monza, University of Milano Bicocca, Monza, Italy; NeuroMi (Milan Center for Neuroscience), Milan, Italy., Marcheselli S; Neurologia d'urgenza e Stroke Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy., Roncoroni M; Neurology and Stroke Unit, P.O. Saronno, ASST Valle Olona, Varese, Italy., Beretta S; Neurology Unit, Vimercate Hospital, ASST-Brianza, Vimercate, MB, Italy., Lorusso L; Neurological Department, San Leopoldo Mandic Hospital, ASST, Lecco, Merate, Italy., Cavallini A; Neurologia d'Urgenza e Stroke Unit, IRCCS Fondazione Mondino, Pavia, Italy., Prelle A; Neurology, ASST Ovest Milanese, Legnano, Italy., Guidetti D; Neurology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy., La Gioia S; Department of neurology, Papa Giovanni XXIII Hospital, Bergamo, Italy., Canella S; Neurology and Stroke Unit, San Giuseppe-Multimedica Hospital, Milan, Italy., Zanferrari C; Neurology and Stroke Unit, PO Vizzolo Predabissi, ASST Melegnano Martesana, Milan, Italy., Grampa G; Neurology Unit, S. Anna Hospital, Como, Italy., d'Adda E; Neurology Unit, Ospedale Maggiore di Crema, ASST Crema, Crema, Italy., Peverelli L; Neurology, Ospedale Maggiore di Lodi, ASST, Lodi, Italy., Colombo A; Polo Neurologico Brianteo, Seregno, MB, Italy., Martinelli-Boneschi F; Dino Ferrari Centre, Neuroscience Section, Department of Pathophysiology and Transplantation (DEPT), University of Milan, Via Francesco Sforza 35, 20122 Milan, Italy; Neurology Unit and MS Centre, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy., Salmaggi A; Neurological Department, 'Alessandro Manzoni' Hospital, ASST, Lecco, Via dell'Eremo 9/11, 23900 Lecco, Italy.
Jazyk: angličtina
Zdroj: Journal of the neurological sciences [J Neurol Sci] 2023 Nov 15; Vol. 454, pp. 120848. Date of Electronic Publication: 2023 Oct 31.
DOI: 10.1016/j.jns.2023.120848
Abstrakt: Introduction: COVID-19 pandemic had a great impact on outcome in SARS-CoV-2 positive patients with ischemic stroke during the first wave in Italy. Few data are available on outcome stratified by sex.
Methods: The Italian Society of Hospital Neuroscience conducted a multi-center, retrospective, observational study on neurological complications in COVID-19 patients with ischemic stroke. All the patients admitted from March 1st to April 30th, 2020 in 20 Neurology Units in Northern Italy were recruited. Demographical and clinical features, treatment and outcome data were compared focusing on sex differences.
Results: 812 patients with ischemic stroke were enrolled, of whom 129 with COVID-19; males were 53.8%. In-hospital mortality in COVID-19 patients was 35.3% in males and 27.9% in females while 8.5% in male and 5.8% in female patients without COVID-19. SARS-CoV-2 positive patients had a higher frequency of stroke of undetermined etiology, than negative ones (32.8% vs 22.5%; p = 0.02), especially in females compared to males (36.1% vs 27.9%), albeit without statistical significance. Male patients with SARS-CoV-2 were more likely to require cPAP (30.9% vs 14.8%; p = 0.03), endotracheal tube (14.9% vs 3.3%; p = 0.02) and reperfusion strategies (29.4% vs 11.5%; p = 0.01) than females, as well as to have a higher CRP and D-dimer. These elements together with older age, a total anterior circulation stroke and lymphopenia were predictors of a worse outcome.
Discussion: Our study detected some differences due to sex in ischemic stroke with and without COVID-19, supporting the possibility to perform sex analyses for SARS-CoV-2 positive patients for a better clinical management.
Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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