Acute Cerebrovascular Events With COVID-19 Infection
Author:
Dhamoon Mandip S.1, Thaler Alison1, Gururangan Kapil1ORCID, Kohli Amit1, Sisniega Daniella1, Wheelwright Danielle1, Mensching Connor1, Fifi Johanna T.1, Fara Michael G.1, Jette Nathalie1ORCID, Cohen Ella1, Dave Priya1, DiRisio Aislyn C.1ORCID, Goldstein Jonathan1, Loebel Emma M.1, Mayman Naomi A.1, Sharma Akarsh1, Thomas Daniel S.1ORCID, Vega Perez Ruben D.1, Weingarten Mark R.1, Wen Huei Hsun1, Tuhrim Stanley1, Stein Laura K.1, Weinberger Jesse, Horowitz Deborah, Sheinart Kara, Kummer Benjamin, Hao Qing, Roche Tara, Gizaw Mahalet, Stefanowski Kamil, Goswami Vaibhav, Mocco J, Oxley Thomas, Majidi Shahram, Singh Inder Paul, Shoirah Hazem, DeLeacy Reade, Kellner Christopher, Shimegatsu Tomoyoshi, Yim Benjamin, Ladner Travis, Yaeger Kurt, Skliut Maryna, Boniece Irene, Brockington Carolyn, Dass Punam, Nasrallah Eli, Rudolph Steven, Morhaim Holly, Liang John, Reynolds Alexandra, Dengayach Neha, Lay Cappi, Reilly Kate, Cheung Helen, Chiu Daniel, Peschansky Veronica, Levy Sarah, Erdman John, Baron Rebecca, Charytonowicz Daniel, Gentile Caroline, Lange Marcia, Lurie Jacob, O’Mary Rio, Pai Akila, Sastow Dahniel, Sharma Himanshu, Solmssen Charlotte, Perez Ruben Vega
Affiliation:
1. Department of Neurology, Icahn School of Medicine at Mount Sinai, New York.
Abstract
Background and Purpose:
Coronavirus disease 2019 (COVID-19) has been associated with an increased incidence of thrombotic events, including stroke. However, characteristics and outcomes of COVID-19 patients with stroke are not well known.
Methods:
We conducted a retrospective observational study of risk factors, stroke characteristics, and short-term outcomes in a large health system in New York City. We included consecutively admitted patients with acute cerebrovascular events from March 1, 2020 through April 30, 2020. Data were stratified by COVID-19 status, and demographic variables, medical comorbidities, stroke characteristics, imaging results, and in-hospital outcomes were examined. Among COVID-19-positive patients, we also summarized laboratory test results.
Results:
Of 277 patients with stroke, 105 (38.0%) were COVID-19-positive. Compared with COVID-19-negative patients, COVID-19-positive patients were more likely to have a cryptogenic (51.8% versus 22.3%,
P
<0.0001) stroke cause and were more likely to suffer ischemic stroke in the temporal (
P
=0.02), parietal (
P
=0.002), occipital (
P
=0.002), and cerebellar (
P
=0.028) regions. In COVID-19-positive patients, mean coagulation markers were slightly elevated (prothrombin time 15.4±3.6 seconds, partial thromboplastin time 38.6±24.5 seconds, and international normalized ratio 1.4±1.3). Outcomes were worse among COVID-19-positive patients, including longer length of stay (
P
<0.0001), greater percentage requiring intensive care unit care (
P
=0.017), and greater rate of neurological worsening during admission (
P
<0.0001); additionally, more COVID-19-positive patients suffered in-hospital death (33% versus 12.9%,
P
<0.0001).
Conclusions:
Baseline characteristics in patients with stroke were similar comparing those with and without COVID-19. However, COVID-19-positive patients were more likely to experience stroke in a lobar location, more commonly had a cryptogenic cause, and had worse outcomes.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Advanced and Specialised Nursing,Cardiology and Cardiovascular Medicine,Clinical Neurology
Reference37 articles.
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