1. Characteristics of a COVID-19 Cohort With Large Vessel Occlusion: A Multicenter International Study
- Author
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Jabbour, Pascal, Dmytriw, Adam A, Sweid, Ahmad, Piotin, Michel, Bekelis, Kimon, Sourour, Nader, Raz, Eytan, Linfante, Italo, Dabus, Guilherme, Kole, Max, Martínez-Galdámez, Mario, Nimjee, Shahid M, Lopes, Demetrius K, Hassan, Ameer E, Kan, Peter, Ghorbani, Mohammad, Levitt, Michael R, Escalard, Simon, Missios, Symeon, Shapiro, Maksim, Clarençon, Frédéric, Elhorany, Mahmoud, Vela-Duarte, Daniel, Tahir, Rizwan A, Youssef, Patrick P, Pandey, Aditya S, Starke, Robert M, Naamani, Kareem El, Abbas, Rawad, Hammoud, Bassel, Mansour, Ossama Y, Galvan, Jorge, Billingsley, Joshua T, Mortazavi, Abolghasem, Walker, Melanie, Dibas, Mahmoud, Settecase, Fabio, Heran, Manraj KS, Kuhn, Anna L, Puri, Ajit S, Menon, Bijoy K, Sivakumar, Sanjeev, Mowla, Ashkan, D'Amato, Salvatore, Zha, Alicia M, Cooke, Daniel, Goyal, Mayank, Wu, Hannah, Cohen, Jake, Turkel-Parrella, David, Xavier, Andrew, Waqas, Muhammad, Tutino, Vincent M, Siddiqui, Adnan, Gupta, Gaurav, Nanda, Anil, Khandelwal, Priyank, Tiu, Cristina, Portela, Pere C, de la Ossa, Natalia Perez, Urra, Xabier, de Lera, Mercedes, Arenillas, Juan F, Ribo, Marc, Requena, Manuel, Piano, Mariangela, Pero, Guglielmo, De Sousa, Keith, Al-Mufti, Fawaz, Hashim, Zafar, Nayak, Sanjeev, Renieri, Leonardo, Aziz-Sultan, Mohamed A, Nguyen, Thanh N, Feineigle, Patricia, Patel, Aman B, Siegler, James E, Badih, Khodr, Grossberg, Jonathan A, Saad, Hassan, Gooch, M Reid, Herial, Nabeel A, Rosenwasser, Robert H, Tjoumakaris, Stavropoula, and Tiwari, Ambooj
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Neurosciences ,Clinical Research ,Brain Disorders ,Stroke ,Good Health and Well Being ,Brain Ischemia ,COVID-19 ,Cerebral Infarction ,Humans ,Retrospective Studies ,Thrombectomy ,Treatment Outcome ,SARS-CoV-2 ,Central nervous system ,Cerebrovascular disease ,Hypercoagulable ,Neurology & Neurosurgery ,Clinical sciences ,Biological psychology - Abstract
BackgroundThe mechanisms and outcomes in coronavirus disease (COVID-19)-associated stroke are unique from those of non-COVID-19 stroke.ObjectiveTo describe the efficacy and outcomes of acute revascularization of large vessel occlusion (LVO) in the setting of COVID-19 in an international cohort.MethodsWe conducted an international multicenter retrospective study of consecutively admitted patients with COVID-19 with concomitant acute LVO across 50 comprehensive stroke centers. Our control group constituted historical controls of patients presenting with LVO and receiving a mechanical thrombectomy between January 2018 and December 2020.ResultsThe total cohort was 575 patients with acute LVO; 194 patients had COVID-19 while 381 patients did not. Patients in the COVID-19 group were younger (62.5 vs 71.2; P < .001) and lacked vascular risk factors (49, 25.3% vs 54, 14.2%; P = .001). Modified thrombolysis in cerebral infarction 3 revascularization was less common in the COVID-19 group (74, 39.2% vs 252, 67.2%; P < .001). Poor functional outcome at discharge (defined as modified Ranklin Scale 3-6) was more common in the COVID-19 group (150, 79.8% vs 132, 66.7%; P = .004). COVID-19 was independently associated with a lower likelihood of achieving modified thrombolysis in cerebral infarction 3 (odds ratio [OR]: 0.4, 95% CI: 0.2-0.7; P < .001) and unfavorable outcomes (OR: 2.5, 95% CI: 1.4-4.5; P = .002).ConclusionCOVID-19 was an independent predictor of incomplete revascularization and poor outcomes in patients with stroke due to LVO. Patients with COVID-19 with LVO were younger, had fewer cerebrovascular risk factors, and suffered from higher morbidity/mortality rates.
- Published
- 2022