1. SARS-CoV-2 and Stroke Characteristics: A Report From the Multinational COVID-19 Stroke Study Group
- Author
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Saeideh Aghayari Sheikh Neshin, Guillaume Turc, Georgios Tsivgoulis, Fahimeh Vahabizad, Stefania Mondello, Oluwaseyi Olulana, Thomas Yasuda, Gelareh Banihashemi, Ali Reza Noorian, Mojdeh Ghabaee, Hany Mohamed Aref, Aristeidis H. Katsanos, Sahar Hojjat-Anasri Komachali, Alaleh Vaghefi Far, Saeed Ansari, Francisco Purroy, Leo H. Bonati, Sakineh Ranji-Burachaloo, Juan F. Arenillas, Afshin Borhani-Haghighi, Peyman Nowrouzi-Sohrabi, Ilaria Gandoglia, Zabihollah Babaeepour, Mohammad Hossein Harirchian, Alia Saberi, Vivek Sharma, Fabricio Buchadid Cardoso, Jusun Moon, Nitin Goyal, Arash Kia, Ronen R. Leker, Mercedeh Sepehrnia, João Sargento-Freitas, Apoorva Dev, Asadollah Mir Ghasemi, Mirna Sabra, Mohammad Ghorbani, Aicha Lyoubi, Bruce C.V. Campbell, Saeideh Salehizadeh, Christos Krogias, Shailesh Male, Mehrdad Roozbeh, Elahe Mohammadi-Vosough, Durgesh Chaudhary, Soheil Naderi, Nasrin Rahimian, Konark Malhotra, Mehmet Hanci, Mehdi Farhoudi, Arefeh Babazadeh, Ali Amini Harandi, Ghasem Farahmand, Massimo Del Sette, Martin Punter, Miljenko Crnjakovic, Faezeh Khodadadi, Gian Marco De Marchis, Ashkan Mowla, Nuno Reis Carreira, Fariborz Khorvash, Annemarei Ranta, Zeinab Mohseni Afshar, Orkhan Alizada, Shima Shahjouei, Ana Paula Aires, Diana Aguiar de Sousa, Christoph J. Griessenauer, Ava Hamidi, Seyed Amir Ebrahimzadeh, Farhad Assarzadegan, Jong Ho Park, Hamidreza Mirkarimi, Mostafa Almasi-Dooghaee, Achille Cernigliaro, Jeffrey C Mai, Lawrence Nolan, Mahmoud Reza Azarpazhooh, Leila Poorsaadat, Yasaman Ahmadzadeh, João Pedro Marto, Humain Baharvahdat, Kristi Tempro, Seyed Aidin Sajedi, Teresa Mesquita, Bruno Gonçalves, Venkatesh Avula, Manuel Requena, Jason J. Chang, Mika Niemelä, Zeynab Sadat Hasheminejad, Branko Malojčić, Elsa Azevedo, Abhi Pandhi, Debdipto Misra, Ramin Zand, Vida Abedi, Marta Rubiera, Thorsten Steiner, Alireza Vafaei Sadr, Sepideh Paybast, Rohan Arora, Behnam Rezai Jahromi, Firas Kobeissy, Jiang Li, Daniel Bock, Behnam Sabayan, Eric Koza, Joan Montaner, Lev Lotman, Mercedes de Lera Alfonso, Carlo W. Cereda, Mahtab Ramezani, Matthew S. Tenser, Duchange, Nathalie, Geisinger Health System [Danville, PA, USA], National and Kapodistrian University of Athens (NKUA), Attikon University Hospital, Tehran University of Medical Sciences (TUMS), Geisinger Commonwealth School of Medicine [Scranton, PA, USA], University of Southern California (USC), Université de Genève = University of Geneva (UNIGE), Icahn School of Medicine at Mount Sinai [New York] (MSSM), University of Messina, Regional Health Authority of Sicily [Palermo], University of Otago [Dunedin, Nouvelle-Zélande], PES University [Bangalore], Lebanese University [Beirut] (LU), Shahid Beheshti University of Medical Sciences [Tehran] (SBUMS), Hôpital Delafontaine, Centre Hospitalier de Saint-Denis [Ile-de-France], University of Melbourne, Universidad de Valladolid [Valladolid] (UVa), Klinikum Frankfurt Höchst, University Hospital Virgen Macarena [Sevilla], Poursina Hospital, Universidade de Lisboa = University of Lisbon (ULISBOA), Centro Hospitalar Universitário de São João [Porto], Universidade do Porto = University of Porto, Cerrahpasa Faculty of Medicine, Istanbul University, University of Tennessee [Chattanooga] (UTC), Valiasr Hospital [Borujen], University Hospital Basel [Basel], Neurocenter of Southern Switzerland, Ospedale Regionale di Lugano, MedStar Washington Hospital Center, Clinical Hospital Dubrava [Zagreb, Croatia] (CHD), University of Basel (Unibas), Galliera Hospital [Genova, Italy], Yasrebi Hospital [Kashan, Iran] (YH), Tabriz University of Medical Sciences [Tabriz, Iran] (TUOMS), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), McMaster University [Hamilton, Ontario], Ruhr University Bochum (RUB), Hadassah Hebrew University Medical Center [Jerusalem], Albany Medical College, Georgetown University Medical Center, Vidant Medical Center [Greenville, NC, USA] (VMC), Allegheny Health Network [Pittsburgh, PA, USA] (AHN), University Hospital Centre Zagreb, Partenaires INRAE, University of Zagreb, Hospital De Egas Moniz [Lisbon], University of Ottawa [Ottawa], Ain Shams University (ASU), Kermanshah University of Medical Sciences, Asan Medical Center [Seoul], University of Ulsan, Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Helsinki University Hospital, Hanyang University College of Medicine, Universitat de Lleida, Vall d'Hebron University Hospital [Barcelona], Universitat Autònoma de Barcelona (UAB), Golestan University of Medical Sciences, Universidade de Coimbra [Coimbra], National University Health System [Singapore] (NUHS), Heidelberg University Hospital [Heidelberg], Hospital for Special Surgery, Iran University of Medical Sciences, Shahid Beheshti University, Babol University of Medical Sciences, Mashhad University of Medical Sciences, Centro Médico de Campinas [São Paulo], Gheshm Hospital, Gilan University of Medical Sciences [Lahijan], Isfahan University of Medical Sciences [Iran] (MUI), University of Florida [Gainesville] (UF), Modarres Hospital [Kashmar], Southern California Permanente Medical Group, Shiraz University of Medical Sciences [Iran] (SUMS), Qazvin University of Medical Sciences, Arak University of Medical Sciences, Harvard Medical School [Boston] (HMS), Salahadin Ayubi Hospital [Baneh], University of Western Ontario (UWO), Long Island Jewish Forest Hills [New York], Biocomplexity Institute of Virginia Tech [Blacksburg], Virginia Tech [Blacksburg], Department of Neurosciences, HUS Neurocenter, Neurokirurgian yksikkö, Clinicum, University of Geneva [Switzerland], Universidade de Lisboa (ULISBOA), Universidade do Porto, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Hospital De Egas Moniz [Lisbon, Portugal] (Centro Hospitalar Lisboa Ocidental), and University of Helsinki
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Male ,Cerebrovascular disorders ,MESH: Geography ,Epidemiology ,International Cooperation ,SUBTYPES ,0302 clinical medicine ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Prospective Studies ,Young adult ,Cerebral Venous Thrombosis ,MESH: Treatment Outcome ,Subtypes ,neuroimaging ,MESH: Middle Aged ,MESH: Risk ,Geography ,STATEMENT ,cerebrovascular disorders ,intracranial hemorrhages ,stroke ,venous thrombosis ,virus diseases ,Countries ,3. Good health ,MESH: Young Adult ,Cardiology and Cardiovascular Medicine ,MESH: Intracranial Hemorrhages ,COUNTRIES ,medicine.medical_specialty ,Registry ,MESH: Health Expenditures ,03 medical and health sciences ,1ST-EVER ISCHEMIC-STROKE ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Humans ,Aged ,Ischemic Stroke ,Advanced and Specialized Nursing ,MESH: Humans ,3112 Neurosciences ,MESH: Adult ,medicine.disease ,MESH: International Cooperation ,nervous system ,RISK-FACTORS ,Observational study ,Neurology (clinical) ,Statement ,Health Expenditures ,Young-Adults ,MESH: Female ,030217 neurology & neurosurgery ,viruses ,030204 cardiovascular system & hematology ,Sinus Thrombosis, Intracranial ,Venous thrombosis ,YOUNG-ADULTS ,Risk-Factors ,EPIDEMIOLOGY ,MESH: COVID-19 ,Prospective cohort study ,Stroke ,MESH: Aged ,musculoskeletal, neural, and ocular physiology ,CEREBRAL VENOUS THROMBOSIS ,Middle Aged ,[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Treatment Outcome ,MESH: Sinus Thrombosis, Intracranial ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Female ,medicine.symptom ,Interstroke ,MESH: Ischemic Stroke ,Adult ,Risk ,Subarachnoid hemorrhage ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Neuroimaging ,macromolecular substances ,Asymptomatic ,Young Adult ,INTERSTROKE ,Aneurysm ,Internal medicine ,medicine ,cardiovascular diseases ,business.industry ,COVID-19 ,Artery occlusions ,MESH: Male ,MESH: Prospective Studies ,Intracranial hemorrhages ,REGISTRY ,MESH: Venous Thrombosis ,1st-Ever Ischemic-Stroke ,business - Abstract
Background and Purpose: Stroke is reported as a consequence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in several reports. However, data are sparse regarding the details of these patients in a multinational and large scale. Methods: We conducted a multinational observational study on features of consecutive acute ischemic stroke, intracranial hemorrhage, and cerebral venous or sinus thrombosis among SARS-CoV-2–infected patients. We further investigated the risk of large vessel occlusion, stroke severity as measured by the National Institutes of Health Stroke Scale, and stroke subtype as measured by the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria among patients with acute ischemic stroke. In addition, we explored the neuroimaging findings, features of patients who were asymptomatic for SARS-CoV-2 infection at stroke onset, and the impact of geographic regions and countries’ health expenditure on outcomes. Results: Among the 136 tertiary centers of 32 countries who participated in this study, 71 centers from 17 countries had at least 1 eligible stroke patient. Of 432 patients included, 323 (74.8%) had acute ischemic stroke, 91 (21.1%) intracranial hemorrhage, and 18 (4.2%) cerebral venous or sinus thrombosis. A total of 183 (42.4%) patients were women, 104 (24.1%) patients were P =0.02) and higher rate of mechanical thrombectomy (12.4% versus 2%; P Conclusions: We observed a considerably higher rate of large vessel occlusions, a much lower rate of small vessel occlusion and lacunar infarction, and a considerable number of young stroke when compared with the population studies before the pandemic. The rate of mechanical thrombectomy was significantly lower in countries with lower health expenditures.
- Published
- 2021
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