Abstract
Background and purpose: We evaluated whether stroke severity, functional outcome, and mortality are different in patients with ischemic stroke with or without coronavirus disease 2019 (COVID-19) infection.
Methods: A prospective, observational, multicentre cohort study in Catalonia, Spain. Recruitment was consecutive from mid-March to mid-May 2020. Patients had an acute ischemic stroke within 48 hours and a previous modified Rankin Scale (mRS) score of 0 to 3. We collected demographic data, vascular risk factors, prior mRS score, National Institutes of Health Stroke Scale score, rate of reperfusion therapies, logistics, and metrics. Primary end point was functional outcome at 3 months. Favourable outcome was defined depending on the previous mRS score. Secondary outcome was mortality at 3 months. We performed mRS shift and multivariable analyses.
Results: We evaluated 701 patients (mean age 72.3±13.3 years, 60.5% men) and 91 (13%) had COVID-19 infection. Median baseline National Institutes of Health Stroke Scale score was higher in patients with COVID-19 compared with patients without COVID-19 (8 [3-18] versus 6 [2-14], P =0.049). Proportion of patients with a favourable functional outcome was 33.7% in the COVID-19 and 47% in the non-COVID-19 group. However, after a multivariable logistic regression analysis, COVID-19 infection did not increase the probability of unfavourable functional outcome. Mortality rate was 39.3% among patients with COVID-19 and 16.1% in the non-COVID-19 group. In the multivariable logistic regression analysis, COVID-19 infection was a risk factor for mortality (hazard ratio, 3.14 [95% CI, 2.10-4.71]; P <0.001).
Conclusions: Patients with ischemic stroke and COVID-19 infection have more severe strokes and a higher mortality than patients with stroke without COVID-19 infection. However, functional outcome is comparable in both groups.
Keywords: cerebrovascular disease; coronavirus; pandemics; prognosis; reperfusion; stroke; thrombectomy.
【저자키워드】 coronavirus, Prognosis, stroke, Pandemics, Cerebrovascular disease, reperfusion, thrombectomy., 【초록키워드】 COVID-19, coronavirus disease, Risk factors, Mortality, severity, Infection, outcome, risk factor, cohort study, Probability, COVID-19 infection, Patient, Spain, age, multicentre, scale, Therapies, Analysis, Metrics, Vascular, hazard ratio, multivariable logistic regression, demographic data, end point, multivariable analyses, non-COVID-19 group, men, secondary, defined, performed, collected, evaluated, functional, comparable, 48 hour, baseline, in both groups, patients with COVID-19, patients without COVID-19, 【제목키워드】 COVID-19, Impact, Ischemic,