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Impact of COVID-19 Infection on the Outcome of Patients With Ischemic Stroke

2021; Lippincott Williams & Wilkins; Volume: 52; Issue: 12 Linguagem: Inglês

10.1161/strokeaha.121.034883

1524-4628

Joan Martí‐Fàbregas, Daniel Guisado‐Alonso, Raquel Delgado‐Mederos, Alejandro Martínez‐Domeño, Luís Prats‐Sánchez, Marina Guasch‐Jiménez, Pere Cardona, Ana Núñez-Guillén, Manuel Requena, Marta Rubiera, Marta Olivé‐Gadea, Alejandro Bustamante, Meritxell Gomis, Sergio Amaro, Laura Llull, Xavier Ustrell, Gislaine Castilho de Oliveira, Laia Seró, Manuel Gómez‐Choco, Luis J. Mena, Joaquı́n Serena, Saima Bashir, Francisco Purroy, Mikel Vicente‐Pascual, Ana Rodríguez-Campello, Ángel Ois, Esther Catena, M.C. García-Carreira, Oriol Barrachina, Ernest Palomeras, Jerzy Krupiński, Marta Almería, Josep Zaragoza, Patricia Esteve, Dolores Cocho, Antía Moreira, Cecile van Eendenburg, Javier Codas, Natàlia Pérez de la Ossa, Mercé Salvat, Pol Camps‐Renom,

COVID-19 Clinical Research Studies

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.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.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).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.