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European Multicenter Study of ET-COVID-19

2020; Lippincott Williams & Wilkins; Volume: 52; Issue: 1 Linguagem: Inglês

10.1161/strokeaha.120.031514

1524-4628

Fédérico Cagnazzo, Michel Piotin, Simon Escalard, Benjamin Maïer, Marc Ribó, Manuel Requena, Raoul Pop, Anca Hasiu, Roberto Gasparotti, Dikran Mardighian, Mariangela Piano, Amedeo Cervo, Omer Eker, Vincent Durous, Nader Sourour, Mahmoud Elhorany, Andrea Zini, L. Simonetti, Simona Marcheselli, Nunzio Paolo Nuzzi, Emmanuel Houdart, Alexis Guédon, Noémie Ligot, Benjamin Mine, Arturo Consoli, Bertrand Lapergue, Pere Cordona Portela, Xabier Urra, Alejandro Rodríguez-Vázquez, Federico Bolognini, Pablo Ariel Lebedinsky, A. Pasco-Papon, Sophie Godard, Gaultier Marnat, Igor Sibon, Nicola Limbucci, Patrizia Nencini, Sergio Nappini, Valentina Saia, Valentina Caldiera, Daniele Giuseppe Romano, Giulia Frauenfelder, Ivan Gallesio, Giuliano Gola, R. Menozzi, Antonio Genovese, Alberto Terrana, Andrea Giorgianni, Manuel Cappellari, Raffaele Augelli, Paolo Invernizzi, Marco Pavia, Elvis Lafe, Anna Cavallini, Alessia Giossi, Michele Besana, Luca Valvassori, Antonio Macera, Lucio Castellan, Giancarlo Salsano, Fortunato Di Caterino, Alessandra Biondi, Caroline Arquizan, Julien Lebreuche, Gianluca Galvano, Alfio Cannella, Mirco Cosottini, Guido Andrea Lazzarotti, Giuseppe Guizzardi, Alessandro Stecco, Rossana Tassi, Sandra Bracco, Elena Bianchini, Camilla Micieli, Rosario Pascarella, Manuela Napoli, Francesco Causin, Hubert Desal, François Cotton, Vincent Costalat, François Delvoye, Gabriele Cicciò, Stanislas Smajda, Hocine Redjem, Solène Hébert, Raphaël Blanc, Mikaël Mazighi, Jean-Philippes Desilles, Dan Mihoc, Monica Manisor, Rémy Beaujeux, Véronique Quenardelle, Roxana Gheoca, Valérie Wolff, Guglielmo Pero, Giussani Giuditta, Chiara Ceresa, Roberto Riva, Matteo Cappucci, Morgane Laubacher, Célia Tuttle, Lorenzo Piergallini, Francis Turjman, Frédéric Clarençon, Eimad Shotar, Stéphanie Lenck, Kévin Premat, Vincent Degos, Yves Samson, Charlotte Rosso, Sonia Alamowitch, Luigi Cirillo, Mauro Gentile, Ludovica Migliaccio, Salvatore Isceri, Símone Rossi, Tommaso Baldini, M. Dall’Olio, M. Cellerini, Jean‐Pierre Saint‐Maurice, Vittorio Civelli, Matteo Fantoni, Gilles Naeije, Lise Jodaïtis, Boris Lubicz, Stéphanie Elens, Thomas Bonnet, Adrien Guenego, Niloufar Sadeghi, Van Nuffelen Marc, Federico Di Maria, Oguzhan Coskun, Georges Rodesch, Sergio Zimatore, Florent Gariel, Jérôme Berge, Patrice Ménégon, Xavier Barreau, Thomas Tourdias, Stéphane Olindo, Ludovic Lucas, Jean-Sébastien Liegey, Sharmila Sagnier, Pauline Renou, Marie Couture, Sabrina Debruxelles, Mathilde Poli, M. Musacchio, Mariette Delaître, R. Padolecchia, Giuseppe Ganci, Annalisa Sugo, Stefano Barbero, Taverna Giacomo Giovanni, Umberto Scoditti, Paola Castellini, Lilia Latte, Ilaria Grisendi, Enrico Epifani, Francesco Alberto Vizzari, Stefano Molinaro, Luca Nativo, Gabriele Vinacci, Bruno Bonetti, Nicola Micheletti, Giampaolo Tomelleri, P. Zampieri, Mauro Plebani, Andrea Grazioli, Giuseppe Kenneth Ricciardi, Alessandra Polistena, Sgreccia Alessando, Giuseppina Sanfilippo, Alessandra Persico, William Boadu, Maria Giovanna Cuzzoni, Serena Magno, Gianpaolo Toscano, Maria Federica Denaro, P. Tosi, Bruno Censori, Valentina Puglisi, Luisa Vinciguerra, Valeria De Giuli, Nicola Mavillo, Leonardo Renieri, Enrico Fainardi, Giovanni Vitale, Panagiotis Primikiris, Guillaume Charbonnier, Claudio Moratti, Fabrizio Sallustio, Andrea Wlderk, Riccardo Russo, Mauro Bergui, Chiara Comelli, Andrea Boghi, Marinette Moynier, Elisa Ciceri, Danilo Toni, Julien Frandon, Isabelle Mourand, Nicolas Gaillard, Salvatore Mangiafico, Imad Derraz, Cyril Dargazanli, Pierre-Henri Lefèvre, Carlos Riquelme, Grégory Gascou, Alain Bonafé,

Retinal and Optic Conditions

Acute ischemic stroke and large vessel occlusion can be concurrent with the coronavirus disease 2019 (COVID-19) infection. Outcomes after mechanical thrombectomy (MT) for large vessel occlusion in patients with COVID-19 are substantially unknown. Our aim was to study early outcomes after MT in patients with COVID-19.Multicenter, European, cohort study involving 34 stroke centers in France, Italy, Spain, and Belgium. Data were collected between March 1, 2020 and May 5, 2020. Consecutive laboratory-confirmed COVID-19 cases with large vessel occlusion, who were treated with MT, were included. Primary investigated outcome: 30-day mortality.early neurological improvement (National Institutes of Health Stroke Scale improvement ≥8 points or 24 hours National Institutes of Health Stroke Scale 0-1), successful reperfusion (modified Thrombolysis in Cerebral Infarction grade ≥2b), and symptomatic intracranial hemorrhage.We evaluated 93 patients with COVID-19 with large vessel occlusion who underwent MT (median age, 71 years [interquartile range, 59-79]; 63 men [67.7%]). Median pretreatment National Institutes of Health Stroke Scale and Alberta Stroke Program Early CT Score were 17 (interquartile range, 11-21) and 8 (interquartile range, 7-9), respectively. Anterior circulation acute ischemic stroke represented 93.5% of cases. The rate modified Thrombolysis in Cerebral Infarction 2b to 3 was 79.6% (74 patients [95% CI, 71.3-87.8]). Thirty-day mortality was 29% (27 patients [95% CI, 20-39.4]). Early neurological improvement was 19.5% (17 patients [95% CI, 11.8-29.5]), and symptomatic intracranial hemorrhage was 5.4% (5 patients [95% CI, 1.7-12.1]). Patients who died at 30 days exhibited significantly lower lymphocyte count, higher levels of aspartate, and LDH (lactate dehydrogenase). After adjustment for age, initial National Institutes of Health Stroke Scale, Alberta Stroke Program Early CT Score, and successful reperfusion, these biological markers remained associated with increased odds of 30-day mortality (adjusted odds ratio of 2.70 [95% CI, 1.21-5.98] per SD-log decrease in lymphocyte count, 2.66 [95% CI, 1.22-5.77] per SD-log increase in aspartate, and 4.30 [95% CI, 1.43-12.91] per SD-log increase in LDH).The 29% rate of 30-day mortality after MT among patients with COVID-19 is not negligible. Abnormalities of lymphocyte count, LDH and aspartate may depict a patient's profiles with poorer outcomes after MT. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT04406090.