SARS-CoV-2 and Stroke Characteristics A Report From the Multinational COVID-19 Stroke Study Group

• Type: Article in International Scientific Journal
• Date: 2021

Authors

Shahjouei, S (Author) Other; Tsivgoulis, G (Author) Other; Farahmand, G (Author) Other; Koza, E (Author) Other; Mowla, A (Author) Other; Sadr, AV (Author) Other; Kia, A (Author) Other; Far, AV (Author) Other; Mondello, S (Author) Other; Cernigliaro, A (Author) Other; Ranta, A (Author) Other; Punter, M (Author) Other; Khodadadi, F (Author) Other; Naderi, S (Author) Other; Sabra, M (Author) Other; Ramezani, M (Author) Other; Harandi, AA (Author) Other; Olulana, O (Author) Other; Chaudhary, D (Author) Other; Lyoubi, A (Author) Other; Campbell, BCV (Author) Other; Arenillas, JF (Author) Other; Bock, D (Author) Other; Montaner, J (Author) Other; Neshin, SAS (Author) Other; de Sousa, DA (Author) Other; Tenser, MS (Author) Other; Aires, A (Author) Other; Alfonso, MD (Author) Other; Alizada, O (Author) Other; Elsa Azevedo (Author) FMUP; Goyal, N (Author) Other; Babaeepour, Z (Author) Other; Banihashemi, G (Author) Other; Bonati, LH (Author) Other; Cereda, CW (Author) Other; Chang, JJ (Author) Other; Crnjakovic, M (Author) Other; De Marchis, GM (Author) Other; Del Sette, M (Author) Other; Ebrahimzadeh, SA (Author) Other; Farhoudi, M (Author) Other; Gandoglia, I (Author) Other; Goncalves, B (Author) Other; Griessenauer, CJ (Author) Other; Hanci, MM (Author) Other; Katsanos, AH (Author) Other; Krogias, C (Author) Other; Leker, RR (Author) Other; Lotman, L (Author) Other; Mai, J (Author) Other; Male, S (Author) Other; Malhotra, K (Author) Other; Malojcic, B (Author) Other; Mesquita, T (Author) Other; Ghasemi, AM (Author) Other; Aref, HM (Author) Other; Afshar, ZM (Author) Other; Moon, J (Author) Other; Niemela, M (Author) Other; Jahromi, BR (Author) Other; Nolan, L (Author) Other; Pandhi, A (Author) Other; Park, JH (Author) Other; Marto, JP (Author) Other; Purroy, F (Author) Other; Ranji Burachaloo, S (Author) Other; Carreira, NR (Author) Other; Requena, M (Author) Other; Rubiera, M (Author) Other; Sajedi, SA (Author) Other; Sargento Freitas, J (Author) Other; Sharma, VK (Author) Other; Steiner, T (Author) Other; Tempro, K (Author) Other; Turc, G (Author) Other; Ahmadzadeh, Y (Author) Other; Almasi Dooghaee, M (Author) Other; Assarzadegan, F (Author) Other; Babazadeh, A (Author) Other; Baharvandat, H (Author) Other; Cardoso, FB (Author) Other; Dev, A (Author) Other; Ghorbani, M (Author) Other; Hamidi, A (Author) Other; Hasheminejad, ZS (Author) Other; Komachali, SHA (Author) Other; Khorvash, F (Author) Other; Kobeissy, F (Author) Other; Mirkarimi, H (Author) Other; Mohammadi Vosough, E (Author) Other; Misra, D (Author) Other; Noorian, AR (Author) Other; Nowrouzi Sohrabi, P (Author) Other; Paybast, S (Author) Other; Poorsaadat, L (Author) Other; Roozbeh, M (Author) Other; Sabayan, B (Author) Other; Salehizadeh, S (Author) Other; Saberi, A (Author) Other; Sepehrnia, M (Author) Other; Vahabizad, F (Author) Other; Yasuda, TA (Author) Other; Ghabaee, M (Author) Other; Rahimian, N (Author) Other; Harirchian, MH (Author) Other; Borhani Haghighi, A (Author) Other; Azarpazhooh, MR (Author) Other; Arora, R (Author) Other; Ansari, S (Author) Other; Avula, V (Author) Other; Li, J (Author) Other; Abedi, V (Author) Other; Zand, R (Author) Other

Journal

Title: Stroke

Vol. 52

Pages: E117-E130

ISSN: 0039-2499

Publisher: Wolters Kluwer Health

Indexing

ISI Web of Knowledge - 7 Citations

Scopus - 57 Citations

Other information

Authenticus ID: P-00T-WJ9

DOI: 10.1161/strokeaha.120.032927

Abstract (EN): BACKGROUND AND PURPOSE: Stroke is reported as a consequence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in several reports. However, data are sparse regarding the details of these patients in a multinational and large scale. METHODS: We conducted a multinational observational study on features of consecutive acute ischemic stroke, intracranial hemorrhage, and cerebral venous or sinus thrombosis among SARS-CoV-2-infected patients. We further investigated the risk of large vessel occlusion, stroke severity as measured by the National Institutes of Health Stroke Scale, and stroke subtype as measured by the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria among patients with acute ischemic stroke. In addition, we explored the neuroimaging findings, features of patients who were asymptomatic for SARS-CoV-2 infection at stroke onset, and the impact of geographic regions and countries' health expenditure on outcomes. RESULTS: Among the 136 tertiary centers of 32 countries who participated in this study, 71 centers from 17 countries had at least 1 eligible stroke patient. Of 432 patients included, 323 (74.8%) had acute ischemic stroke, 91 (21.1%) intracranial hemorrhage, and 18 (4.2%) cerebral venous or sinus thrombosis. A total of 183 (42.4%) patients were women, 104 (24.1%) patients were <55 years of age, and 105 (24.4%) patients had no identifiable vascular risk factors. Among acute ischemic stroke patients, 44.5% (126 of 283 patients) had large vessel occlusion; 10% had small artery occlusion according to the TOAST criteria. We observed a lower median National Institutes of Health Stroke Scale (8 [3-17] versus 11 [5-17]; P=0.02) and higher rate of mechanical thrombectomy (12.4% versus 2%; P<0.001) in countries with middle-to-high health expenditure when compared with countries with lower health expenditure. Among 380 patients who had known interval onset of the SARS-CoV-2 and stroke, 144 (37.8%) were asymptomatic at the time of admission for SARS-CoV-2 infection. CONCLUSIONS: We observed a considerably higher rate of large vessel occlusions, a much lower rate of small vessel occlusion and lacunar infarction, and a considerable number of young stroke when compared with the population studies before the pandemic. The rate of mechanical thrombectomy was significantly lower in countries with lower health expenditures.

Language: English

Type (Professor's evaluation): Dissemination

No. of pages: 14