Safety and Outcome of Revascularization Treatment in Patients With Acute Ischemic Stroke and COVID-19: The Global COVID-19 Stroke Registry

• Type: Article in International Scientific Journal
• Date: 2022

Authors

Marto, JP (Author) Other; Strambo, D (Author) Other; Ntaios, G (Author) Other; Nguyen, TN (Author) Other; Herzig, R (Author) Other; Czlonkowska, A (Author) Other; Demeestere, J (Author) Other; Mansour, OY (Author) Other; Salerno, A (Author) Other; Wegener, S (Author) Other; Baumgartner, P (Author) Other; Cereda, CW (Author) Other; Bianco, G (Author) Other; Beyeler, M (Author) Other; Arnold, M (Author) Other; Carrera, E (Author) Other; Machi, P (Author) Other; Altersberger, V (Author) Other; Bonati, L (Author) Other; Gensicke, H (Author) Other; Bolognese, M (Author) Other; Peters, N (Author) Other; Wetzel, S (Author) Other; Magriço, M (Author) Other; Ramos, JN (Author) Other; Sargento Freitas, J (Author) Other; Machado, R (Author) Other; Maia, C (Author) Other; Machado, E (Author) Other; Nunes, AP (Author) Other; Ferreira, P (Author) Other; Pinho e Melo, T (Author) Other; Dias, MC (Author) Other; Paula, A (Author) Other; Correia, MA (Author) Other; Castro, P (Author) Other; Elsa Azevedo (Author) FMUP; Albuquerque, L (Author) Other; Alves, JN (Author) Other; Ferreira Pinto, J (Author) Other; Meira, T (Author) Other; Pereira, L (Author) Other; Rodrigues, M (Author) Other; Araujo, AP (Author) Other; Rodrigues, M (Author) Other; Rocha, M (Author) Other; Pereira Fonseca, Â (Author) Other; Ribeiro, L (Author) Other; Varela, R (Author) Other; Malheiro, S (Author) Other; Cappellari, M (Author) Other; Zivelonghi, C (Author) Other; Sajeva, G (Author) Other; Zini, A (Author) Other; gentile, m (Author) Other; Forlivesi, S (Author) Other; Migliaccio, L (Author) Other; Sessa, M (Author) Other; La Gioia, S (Author) Other; Pezzini, A (Author) Other; Sangalli, D (Author) Other; Zedde, M (Author) Other; Pascarella, R (Author) Other; Ferrarese, C (Author) Other; Beretta, S (Author) Other; Diamanti, S (Author) Other; Schwarz, G (Author) Other; Frisullo, G (Author) Other; Marcheselli, S (Author) Other; Seners, P (Author) Other; Sabben, C (Author) Other; Escalard, S (Author) Other; Piotin, M (Author) Other; Maïer, B (Author) Other; Charbonnier, G (Author) Other; Vuillier, F (Author) Other; Legris, L (Author) Other; Cuisenier, P (Author) Other; Vodret, FR (Author) Other; Marnat, G (Author) Other; Liegey, J (Author) Other; Sibon, I (Author) Other; Flottmann, F (Author) Other; Broocks, G (Author) Other; Gloyer, N (Author) Other; Bohmann, FO (Author) Other; Schaefer, JH (Author) Other; Nolte, C (Author) Other; Audebert, HJ (Author) Other; Siebert, E (Author) Other; Sykora, M (Author) Other; Lang, W (Author) Other; Ferrari, J (Author) Other; Mayer Suess, L (Author) Other; Knoflach, M (Author) Other; Gizewski, ER (Author) Other; Stolp, J (Author) Other; Stolze, LJ (Author) Other; Coutinho, JM (Author) Other; Nederkoorn, P (Author) Other; van den Wijngaard, I (Author) Other; De Meris, J (Author) Other; Lemmens, R (Author) Other; De Raedt, S (Author) Other; Vandervorst, F (Author) Other; Rutgers, MP (Author) Other; Guilmot, A (Author) Other; Dusart, A (Author) Other; Bellante, F (Author) Other; Calleja Castaño, P (Author) Other; Ostos, F (Author) Other; González Ortega, G (Author) Other; Martín Jiménez, P (Author) Other; García Madrona, S (Author) Other; Cruz Culebras, A (Author) Other; Vera, R (Author) Other; Matute, MC (Author) Other; Fuentes, B (Author) Other; Alonso de Leciñana, M (Author) Other; Rigual, R (Author) Other; Díez Tejedor, E (Author) Other; Perez Sanchez, S (Author) Other; Montaner, J (Author) Other; Díaz Otero, F (Author) Other; Pérez de la Ossa, N (Author) Other; Flores Pina, B (Author) Other; Muñoz Narbona, L (Author) Other; Chamorro, A (Author) Other; Rodríguez Vázquez, A (Author) Other; Renú, A (Author) Other; Ayo Martin, O (Author) Other; Hernández Fernández, F (Author) Other; Segura, T (Author) Other; Tejada Meza, H (Author) Other; Sagarra Mur, D (Author) Other; Serrano Ponz, M (Author) Other; Hlaing, T (Author) Other; See, I (Author) Other; Simister, R (Author) Other; Werring, D (Author) Other; Kristoffersen, ES (Author) Other; Nordanstig, A (Author) Other; Jood, K (Author) Other; Rentzos, A (Author) Other; ¦im¿nek, L (Author) Other; Krají¿ková, D (Author) Other; Krajina, A (Author) Other; Mikulik, R (Author) Other; Cviková, M (Author) Other; Vinklárek, J (Author) Other; ¦koloudík, D (Author) Other; Roubec, M (Author) Other; Hurtikova, E (Author) Other; Hrubý, R (Author) Other; Ostry, S (Author) Other; Skoda, O (Author) Other; Pernicka, M (Author) Other; Jurak, L (Author) Other; Eichlová, Z (Author) Other; Jíra, M (Author) Other; Kovar, M (Author) Other; Panský, M (Author) Other; Mencl, P (Author) Other; Palouskova, H (Author) Other; Tomek, A (Author) Other; Janský, P (Author) Other; Ol¨erová, A (Author) Other; Sramek, M (Author) Other; Havlicek, R (Author) Other; Malý, P (Author) Other; Trakal, L (Author) Other; Fiksa, J (Author) Other; Slovák, M (Author) Other; Karlinski, MA (Author) Other; Nowak, M (Author) Other; Sienkiewicz Jarosz, H (Author) Other; Bochynska, A (Author) Other; Wrona, P (Author) Other; Homa, T (Author) Other; Sawczynska, K (Author) Other; Slowik, A (Author) Other; Wlodarczyk, E (Author) Other; Wiacek, M (Author) Other; Tomaszewska Lampart, I (Author) Other; Sieczkowski, B (Author) Other; Bartosik Psujek, H (Author) Other; Bilik, M (Author) Other; Bandzarewicz, A (Author) Other; Dorobek, M (Author) Other; Zielinska Turek, J (Author) Other; Nowakowska Kotas, M (Author) Other; Obara, K (Author) Other; Urbanowski, P (Author) Other; Budrewicz, S (Author) Other; Guzi¿ski, M (Author) Other; ¿wito¿ska, M (Author) Other; Rutkowska, I (Author) Other; Sobieszak Skura, P (Author) Other; Labuz Roszak, BM (Author) Other; Debiec, A (Author) Other; Staszewski, J (Author) Other; St¿pie¿, A (Author) Other; Zwiernik, J (Author) Other; Wasilewski, G (Author) Other; Tiu, C (Author) Other; Terecoas¿, EO (Author) Other; Radu, RA (Author) Other; Negrila, A (Author) Other; Dorobat, B (Author) Other; Panea, C (Author) Other; Tiu, V (Author) Other; Petrescu, S (Author) Other; Ozdemir, A (Author) Other; Mahmoud, M (Author) Other; El Samahy, H (Author) Other; Abdelkhalek, H (Author) Other; Al Hashel, J (Author) Other; Ismail, II (Author) Other; Salmeen, A (Author) Other; Ghoreishi, A (Author) Other; Sabetay, SI (Author) Other; Gross, H (Author) Other; Klein, P (Author) Other; Abdalkader, M (Author) Other; Jabbour, P (Author) Other; El Naamani, K (Author) Other; Tjoumakaris, S (Author) Other; Abbas, R (Author) Other; Mohamed, GA (Author) Other; Chebl, A (Author) Other; Min, J (Author) Other; Hovingh, M (Author) Other; Tsai, JP (Author) Other; Khan, M (Author) Other; Nalleballe, K (Author) Other; Onteddu, S (Author) Other; Masoud, H (Author) Other; Michael, M (Author) Other; Kaur, N (Author) Other; Maali, L (Author) Other; Abraham, MG (Author) Other; Khandelwal, P (Author) Other; Bach, I (Author) Other; Ong, M (Author) Other; Babici, D (Author) Other; Khawaja, AM (Author) Other; Hakemi, M (Author) Other; Rajamani, K (Author) Other; Cano Nigenda, V (Author) Other; Arauz, A (Author) Other; Amaya, P (Author) Other; Llanos, N (Author) Other; Arango, A (Author) Other; Vences, MÁ (Author) Other; Barrientos Guerra, JD (Author) Other; Caetano, R (Author) Other; Martins, RT (Author) Other; Scollo, SD (Author) Other; Yalung, PM (Author) Other; Nagendra, S (Author) Other; Gaikwad, A (Author) Other; Seo, K (Author) Other; Georgiopoulos, G (Author) Other; Nogueira, RG (Author) Other; Michel, P (Author) Other

Journal

Title: Neurology

ISSN: 0028-3878

Publisher: Wolters Kluwer Health

Indexing

ISI Web of Knowledge - 20 Citations

Other information

Authenticus ID: P-00X-FWG

DOI: 10.1212/wnl.0000000000201537

Abstract (EN): <jats:sec><jats:title>Background and objectives:</jats:title><jats:p>COVID-19 related inflammation, endothelial dysfunction and coagulopathy may increase the bleeding risk and lower efficacy of revascularization treatments in patients with acute ischemic stroke. We aimed to evaluate the safety and outcomes of revascularization treatments in patients with acute ischemic stroke and COVID-19.</jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p>Retrospective multicenter cohort study of consecutive patients with acute ischemic stroke receiving intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) between March 2020 and June 2021, tested for SARS-CoV-2 infection. With a doubly-robust model combining propensity score weighting and multivariate regression, we studied the association of COVID-19 with intracranial bleeding complications and clinical outcomes. Subgroup analyses were performed according to treatment groups (IVT-only and EVT).</jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p>Of a total of 15128 included patients from 105 centers, 853 (5.6%) were diagnosed with COVID-19. 5848 (38.7%) patients received IVT-only, and 9280 (61.3%) EVT (with or without IVT). Patients with COVID-19 had a higher rate of symptomatic intracerebral hemorrhage (SICH) (adjusted odds ratio [OR] 1.53; 95% CI 1.16¿2.01), symptomatic subarachnoid hemorrhage (SSAH) (OR 1.80; 95% CI 1.20¿2.69), SICH and/or SSAH combined (OR 1.56; 95% CI 1.23¿1.99), 24-hour (OR 2.47; 95% CI 1.58¿3.86) and 3-month mortality (OR 1.88; 95% CI 1.52¿2.33).</jats:p><jats:p>COVID-19 patients also had an unfavorable shift in the distribution of the modified Rankin score at 3 months (OR 1.42; 95% CI 1.26¿1.60).</jats:p></jats:sec><jats:sec><jats:title>Discussion:</jats:title><jats:p>Patients with acute ischemic stroke and COVID-19 showed higher rates of intracranial bleeding complications and worse clinical outcomes after revascularization treatments than contemporaneous non-COVID-19 treated patients. Current available data does not allow direct conclusions to be drawn on the effectiveness of revascularization treatments in COVID-19 patients, or to establish different treatment recommendations in this subgroup of patients with ischemic stroke. Our findings can be taken into consideration for treatment decisions, patient monitoring and establishing prognosis.</jats:p></jats:sec>

Language: English

Type (Professor's evaluation): Scientific