Статья

Acute Cerebrovascular Events With COVID-19 Infection

Mandip S. DhamoonDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkAlison ThalerDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkKapil GururanganDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkAmit KohliDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkDaniella SisniegaDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkDanielle WheelwrightDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkConnor MenschingDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkJohanna T FifiDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkMichael FaraDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkNathalie JettéDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkElla CohenDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkPriya DaveDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkAislyn C. DiRisioDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkJonathan GoldsteinDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkEmma LoebelDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkNaomi MaymanDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkAkarsh SharmaDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkDaniel ThomasDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkRuben Vega PerezDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkMark WeingartenDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkHuei Hsun WenDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkStanley TuhrimDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkLaura SteinDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New YorkJesse WeinbergerDeborah HorowitzKara SheinartBenjamin KummerQing HaoTara RocheMahalet GizawKamil StefanowskiVaibhav GoswamiJ MoccoJonathan Goldstein Department of Neurology, Icahn School of Medicine at Mount Sinai, New YorkThomas J. OxleyDaniel S. Thomas https://orcid.org/0000-0002-7925-2205 Department of Neurology, Icahn School of Medicine at Mount Sinai, New YorkShahram MajidiInder Paul SinghHazem ShoirahReade De LeacyChristopher P. KellnerTomoyoshi ShimegatsuBenjamin YimTravis R. LadnerKurt YaegerMaryna SkliutIrene BonieceCarolyn BrockingtonPunam DassE. John NasrallahSteven RudolphHolly MorhaimJohn LiangAlexandra S. ReynoldsNeha DengayachCappi LayKate ReillyHelen CheungDaniel ChiuDaniel S. Thomas https://orcid.org/0000-0002-7925-2205 Department of Neurology, Icahn School of Medicine at Mount Sinai, New YorkVeronica J. PeschanskySarah LevyJohn ErdmanRebecca M. BaronDaniel CharytonowiczDaniel S. Thomas https://orcid.org/0000-0002-7925-2205 Department of Neurology, Icahn School of Medicine at Mount Sinai, New YorkCaroline GentileMarcia LangeJacob LurieRio O’MaryAkila PaiDahniel SastowHimanshu SharmaAkarsh Sharma Department of Neurology, Icahn School of Medicine at Mount Sinai, New YorkCharlotte Solmssen

2020en

ABI

Аннотация

Background and Purpose: Coronavirus disease 2019 (COVID-19) has been associated with an increased incidence of thrombotic events, including stroke. However, characteristics and outcomes of COVID-19 patients with stroke are not well known. Methods: We conducted a retrospective observational study of risk factors, stroke characteristics, and short-term outcomes in a large health system in New York City. We included consecutively admitted patients with acute cerebrovascular events from March 1, 2020 through April 30, 2020. Data were stratified by COVID-19 status, and demographic variables, medical comorbidities, stroke characteristics, imaging results, and in-hospital outcomes were examined. Among COVID-19-positive patients, we also summarized laboratory test results. Results: Of 277 patients with stroke, 105 (38.0%) were COVID-19-positive. Compared with COVID-19-negative patients, COVID-19-positive patients were more likely to have a cryptogenic (51.8% versus 22.3%, P <0.0001) stroke cause and were more likely to suffer ischemic stroke in the temporal ( P =0.02), parietal ( P =0.002), occipital ( P =0.002), and cerebellar ( P =0.028) regions. In COVID-19-positive patients, mean coagulation markers were slightly elevated (prothrombin time 15.4±3.6 seconds, partial thromboplastin time 38.6±24.5 seconds, and international normalized ratio 1.4±1.3). Outcomes were worse among COVID-19-positive patients, including longer length of stay ( P <0.0001), greater percentage requiring intensive care unit care ( P =0.017), and greater rate of neurological worsening during admission ( P <0.0001); additionally, more COVID-19-positive patients suffered in-hospital death (33% versus 12.9%, P <0.0001). Conclusions: Baseline characteristics in patients with stroke were similar comparing those with and without COVID-19. However, COVID-19-positive patients were more likely to experience stroke in a lobar location, more commonly had a cryptogenic cause, and had worse outcomes.

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Идентификаторы

DOI: 10.1161/strokeaha.120.031668

Цитирования и источники

Цитирований: 2Использованных источников: 0

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