Age and Acute Ischemic Stroke Outcome in North American Patients With COVID‐19
| Autor: | Adel M. Malek, Lester Y. Leung, Italo Linfante, Manraj K.S. Heran, Andrew R. Xavier, Hannah Wu, Salvatore D'Amato, Siddharth Sehgal, David Turkel-Parella, Alicia Zha, Adam A Dmytriw, Daniel Cooke, Johanna M. Ospel, A Puri, Mahmoud Dibas, Jake Cohen, Nafee Talukder, Ajay K. Wakhloo, Aman B. Patel, Sanjeev Sivakumar, Robert W. Regenhardt, Daniel Vela-Duarte, Ambooj Tiwari, Anna Luisa Kühn, Ashkan Mowla, Clemens M. Schirmer, Fabio Settecase, Sunil A Sheth, Barbara Voetsch, Aslan Efendizade, Thabele M Leslie-Mazwi, Bijoy K Menon, Joseph Rosenthal, Guilherme Dabus |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Canada acute ischemic stroke medicine.medical_specialty Coronavirus disease 2019 (COVID-19) age outcomes Context (language use) Brief Communication SARS‐CoV‐2 Modified Rankin Scale Internal medicine Vascular Disease Humans Medicine Prospective Studies Prospective cohort study Acute ischemic stroke Stroke Aged Ischemic Stroke Aged 80 and over business.industry Confounding Age Factors COVID-19 COVID‐19 pandemic Odds ratio Middle Aged medicine.disease United States Cerebrovascular Disease/Stroke Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| ISSN: | 2047-9980 |
| DOI: | 10.1161/jaha.121.021046 |
| Popis: | Background Acute ischemic stroke (AIS) in the context of COVID‐19 has received considerable attention for its propensity to affect patients of all ages. We aimed to evaluate the effect of age on functional outcome and mortality following an acute ischemic event. Methods and Results A prospectively maintained database from comprehensive stroke centers in Canada and the United States was analyzed for patients with AIS from March 14 to September 30, 2020 who tested positive for SARS‐CoV‐2. The primary outcome was Modified Rankin Scale score at discharge, and the secondary outcome was mortality. Baseline characteristics, laboratory values, imaging, and thrombectomy workflow process times were assessed. Among all 126 patients with COVID‐19 who were diagnosed with AIS, the median age was 63 years (range, 27–94). There were 35 (27.8%) patients with AIS in the aged ≤55 years group, 47 (37.3%) in the aged 56 to 70 group, and 44 (34.9%) in the aged >70 group. Intravenous tissue plasminogen activator and thrombectomy rates were comparable across these groups, ( P =0.331 and 0.212, respectively). There was a significantly lower rate of mortality between each group favoring younger age (21.9% versus 45.0% versus 48.8%, P =0.047). After multivariable adjustment for possible confounders, a 1‐year increase in age was significantly associated with fewer instances of a favorable outcome of Modified Rankin Scale 0 to 2 (odds ratio [OR], 0.95; 95 CI%, 0.90–0.99; P =0.048) and higher mortality (OR, 1.06; 95 CI%, 1.02–1.10; P =0.007). Conclusions AIS in the context of COVID‐19 affects young patients at much greater rates than pre‐pandemic controls. Nevertheless, instances of poor functional outcome and mortality are closely tied to increasing age. |
| Databáze: | OpenAIRE |
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