Global COVID-19 registry finds strokes associated with COVID-19 are more severe, have worse outcomes and higher mortality

Date:
July 10, 2020
Source:
American Heart Association
Summary:
Patients with COVID-19 who have an acute ischemic stroke (AIS)
experience more severe strokes, have worse functional outcomes and
are more likely to die of stroke than AIS patients who do not have
COVID-19. The wide range of complications associated with COVID-19
likely explain the worse outcomes.



FULL STORY ========================================================================== Acute ischemic strokes (AIS) associated with COVID-19 are more severe,
lead to worse functional outcomes and are associated with higher
mortality , according to new research published yesterday in Stroke,
a journal of the American Stroke Association, a division of the American
Heart Association.


==========================================================================
In "Characteristics and Outcomes in Patients with COVID-19 and Acute
Ischemic Stroke: The Global COVID-19 Stroke Registry," researchers
analyzed data on patients with COVID-19 and AIS treated at 28 health
care centers in 16 countries this year and compared them to patients
without COVID-19 from the Acute Stroke Registry and Analysis of Lausanne (ASTRAL) Registry, from 2003 to 2019. Researchers sought to determine the clinical characteristics and outcomes of patients with COVID-19 and AIS.

Between January 27, 2020 to May 19, 2020, there were 174 patients
hospitalized with COVID-19 and AIS. Each COVID-19 patient with AIS
was matched and compared to a non-COVID-19 AIS patient based on a
set of pre-specified factors including age, gender and stroke risk
factors (hypertension, diabetes, atrial fibrillation, coronary artery
disease, heart failure, cancer, previous stroke, smoking, obesity and dyslipidemia). The final analysis included 330 patients total.

In both patient groups, stroke severity was estimated with the National Institute of Health Stroke Scale (NIHSS), and stroke outcome was assessed
by the modified Rankin score (mRS). When AIS patients with COVID-19 were compared to non-COVID-19 patients:
* COVID-19 patients had more severe strokes (median NIHSS score of
10 vs.

6, respectively);
* COVID-19 patients had higher risk for severe disability following
stroke
(median mRS score 4 vs. 2, respectively); and
* COVID-19 patients were more likely to die of AIS.

The researchers noted there are several potential explanations for
the relationship between COVID-19-associated strokes and increased
stroke severity: "The increased stroke severity at admission in COVID-19-associated stroke patients compared to the non-COVID-19 cohort
may explain the worse outcomes.

The broad, multi-system complications of COVID-19, including acute
respiratory distress syndrome, cardiac arrhythmias, acute cardiac injury, shock, pulmonary embolism, cytokine release syndrome and secondary
infection, probably contribute further to the worse outcomes including
higher mortality in these patients. ... The association highlights the
urgent need for studies aiming to uncover the underlying mechanisms and
is relevant for prehospital stroke awareness and in-hospital acute stroke pathways during the current and future pandemics."

========================================================================== Story Source: Materials provided by American_Heart_Association. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. George Ntaios, Patrik Michel, Georgios Georgiopoulos, Yutao Guo,
Wencheng
Li, Jing Xiong, Patricia Calleja, Fernando Ostos, Guillermo
Gonza'lez- Ortega, Blanca Fuentes, Mari'a Alonso de Lecin~ana,
Exuperio Di'ez- Tejedor, Sebastian Garci'a-Madrona, Jaime Masjuan,
Alicia DeFelipe, Guillaume Turc, Bruno Gonc,alves, Valerie Domigo,
Gheorghe-Andrei Dan, Roxana Vezeteu, Hanne Christensen, Louisa
Marguerite Christensen, Per Meden, Lejla Hajdarevic, Angela
Rodriguez-Lopez, Fernando Di'az-Otero, Andre's Garci'a-Pastor,
Antonio Gil-Nun~ez, Errikos Maslias, Davide Strambo, David
J. Werring, Arvind Chandratheva, Laura Benjamin, Robert Simister,
Richard Perry, Rahma Beyrouti, Pascal Jabbour, Ahmad Sweid,
Stavropoula Tjoumakaris, Elisa Cuadrado-Godia, Ana Rodri'guez
Campello, Jaume Roquer, Tiago Moreira, Michael V. Mazya, Fabio
Bandini, Karl Matz, Helle K. Iversen, Alejandra Gonza'lez-Duarte,
Cristina Tiu, Julia Ferrari, Milan R. Vosko, Helmut J.F. Salzer,
Bernd Lamprecht, Martin W.

Du"nser, Carlo W. Cereda, A'ngel Basilio Corredor Quintero, Eleni
Korompoki, Eduardo Soriano-Navarro, Luis Enrique Soto-Rami'rez,
Paulo F.

Castan~eda-Me'ndez, Daniela Bay-Sansores, Antonio Arauz, Vanessa
Cano- Nigenda, Espen Saxhaug Kristoffersen, Marjaana Tiainen,
Daniel Strbian, Jukka Putaala, Gregory Y.H. Lip. Characteristics
and Outcomes in Patients With COVID-19 and Acute Ischemic
Stroke. Stroke, 2020; DOI: 10.1161/ STROKEAHA.120.031208 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/07/200710131516.htm

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