1. Stroke etiologies in patients with COVID-19: the SVIN COVID-19 multinational registry
- Author
-
María E. Ramos-Araque, James E. Siegler, Marc Ribo, Manuel Requena, Cristina López, Mercedes de Lera, Juan F. Arenillas, Isabel Hernández Pérez, Beatriz Gómez-Vicente, Blanca Talavera, Pere Cardona Portela, Ana Nuñez Guillen, Xabier Urra, Laura Llull, Arturo Renú, Thanh N. Nguyen, Dinesh Jillella, Fadi Nahab, Raul Nogueira, Diogo Haussen, Ryna Then, Jesse M. Thon, Luis Rodríguez Esparragoza, Maria Hernández-Pérez, Alejandro Bustamante, Ossama Yassin Mansour, Mohammed Megahed, Tamer Hassan, David S. Liebeskind, Ameer Hassan, Saif Bushnaq, Mohamed Osman, Alejandro Rodriguez Vazquez, SVIN Multinational Registry and Task Force, Institut Català de la Salut, [Ramos-Araque ME] Institute of Biomedical Research of Salamanca, Department of Neurology, Hospital Universitario de Salamanca, Salamanca, Spain. Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain. [Siegler JE] Cooper Neurologic Institute, Cooper University Hospital, Camden, NJ, USA. [Ribo M, Requena M] Unitat d’Ictus, Servei de Neurologia, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. [López C, de Lera M] Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain, and Vall d'Hebron Barcelona Hospital Campus
- Subjects
Male ,Neurology ,Computed Tomography Angiography ,COVID-19 (Malaltia) ,lcsh:RC346-429 ,Brain Ischemia ,Brain ischemia ,Cohort Studies ,Risk Factors ,Malalties - Factors de risc ,virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES] ,Hospital Mortality ,Registries ,Stroke ,Aged, 80 and over ,Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES] ,General Medicine ,Middle Aged ,Magnetic Resonance Imaging ,Cohort ,Egypt ,Female ,Cohort study ,Research Article ,Adult ,medicine.medical_specialty ,técnicas de investigación::métodos epidemiológicos::estadística como asunto::probabilidad::riesgo::factores de riesgo [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Fibrin Fibrinogen Degradation Products ,Cardiovascular Diseases::Vascular Diseases::Cerebrovascular Disorders::Brain Ischemia [DISEASES] ,Other subheadings::Other subheadings::Other subheadings::/mortality [Other subheadings] ,Internal medicine ,medicine ,Humans ,Mortality ,lcsh:Neurology. Diseases of the nervous system ,Aged ,Ischemic Stroke ,Retrospective Studies ,enfermedades cardiovasculares::enfermedades vasculares::trastornos cerebrovasculares::isquemia cerebral [ENFERMEDADES] ,Otros calificadores::Otros calificadores::Otros calificadores::/mortalidad [Otros calificadores] ,business.industry ,SARS-CoV-2 ,COVID-19 ,Retrospective cohort study ,Stepwise regression ,medicine.disease ,United States ,Coronavirus ,Spain ,Isquèmia cerebral - Mortalitat ,Etiology ,Cryptogenic ,Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Neurology (clinical) ,business - Abstract
Background and purpose Coronavirus disease 2019 (COVID-19) is associated with a small but clinically significant risk of stroke, the cause of which is frequently cryptogenic. In a large multinational cohort of consecutive COVID-19 patients with stroke, we evaluated clinical predictors of cryptogenic stroke, short-term functional outcomes and in-hospital mortality among patients according to stroke etiology. Methods We explored clinical characteristics and short-term outcomes of consecutively evaluated patients 18 years of age or older with acute ischemic stroke (AIS) and laboratory-confirmed COVID-19 from 31 hospitals in 4 countries (3/1/20–6/16/20). Results Of the 14.483 laboratory-confirmed patients with COVID-19, 156 (1.1%) were diagnosed with AIS. Sixty-one (39.4%) were female, 84 (67.2%) white, and 88 (61.5%) were between 60 and 79 years of age. The most frequently reported etiology of AIS was cryptogenic (55/129, 42.6%), which was associated with significantly higher white blood cell count, c-reactive protein, and D-dimer levels than non-cryptogenic AIS patients (pp = 0.01). In that model, older age (aOR 2.05 per decade, 95%CI 1.35–3.11, p p = 0.01) were also independently predictive of mortality. Conclusions Our findings suggest that cryptogenic stroke among COVID-19 patients carries a significant risk of early mortality.
- Published
- 2021