Related Experiment Video
Updated: Dec 12, 2025
Author Spotlight: Assessing Ischemic Stroke Damage Through Middle Cerebral Artery Occlusion Model
Published on: August 11, 2023
Emergent Large Vessel Occlusion Stroke During New York City's COVID-19 Outbreak: Clinical Characteristics and
Shahram Majidi1, Johanna T Fifi1, Travis R Ladner1
1Department of Neurosurgery (S.M., J.T.F., T.R.L., J.L.-R., K.A.Y., B.Y., N.D., T.J.O., T.S., R.D.L., J.M.), Icahn School of Medicine at Mount Sinai, New York, NY.
Insights
During the COVID-19 pandemic, over half of emergent large vessel occlusion (ELVO) stroke patients were COVID-19 positive. This study observed a 2-fold increase in ELVO stroke incidence during the pandemic
Area of Science:
- Neurology
- Infectious Diseases
- Public Health
Background:
- The 2019 novel coronavirus (COVID-19) pandemic has led to increased reports of ischemic stroke, particularly in severe cases.
- Emergent large vessel occlusion (ELVO) is a severe type of ischemic stroke requiring immediate intervention.
Purpose of the Study:
- To evaluate the relationship between emergent large vessel occlusion (ELVO) and the coronavirus disease 2019 (COVID-19) outbreak.
- To compare characteristics of ELVO patients with and without COVID-19 during the pandemic's peak.
Main Methods:
- A retrospective, observational case series was conducted at Mount Sinai Health System Hospitals in New York City.
- Data from ELVO patients during the peak 3 weeks of COVID-19 hospitalizations were analyzed, comparing COVID-19 positive and negative cohorts.
- ELVO stroke incidence was compared to the pre-COVID period.
Main Results:
- Forty-five ELVO patients were identified; 53% tested positive for COVID-19.
- COVID-19 positive patients were younger (59 vs 74 years), more likely male (75% vs 43%), and less likely White (8% vs 38%).
- A 2-fold increase in ELVO incidence was observed during the COVID-19 outbreak compared to a similar pre-COVID period.
Conclusions:
- Over half of ELVO stroke patients during the NYC COVID-19 peak were COVID-19 positive.
- COVID-19 positive ELVO patients exhibited distinct demographic characteristics (younger, male, non-White).
- Findings suggest an increased incidence of ELVO stroke during the COVID-19 pandemic peak.
Background And Purpose:
The 2019 novel coronavirus outbreak and its associated disease (coronavirus disease 2019 [COVID-19]) have created a worldwide pandemic. Early data suggest higher rate of ischemic stroke in severe COVID-19 infection. We evaluated whether a relationship exists between emergent large vessel occlusion (ELVO) and the ongoing COVID-19 outbreak.
Methods:
This is a retrospective, observational case series. Data were collected from all patients who presented with ELVO to the Mount Sinai Health System Hospitals across New York City during the peak 3 weeks of hospitalization and death from COVID-19. Patients' demographic, comorbid conditions, cardiovascular risk factors, COVID-19 disease status, and clinical presentation were extracted from the electronic medical record. Comparison was made between COVID-19 positive and negative cohorts. The incidence of ELVO stroke was compared with the pre-COVID period.
Results:
Forty-five consecutive ELVO patients presented during the observation period. Fifty-three percent of patients tested positive for COVID-19. Total patients' mean (±SD) age was 66 (±17). Patients with COVID-19 were significantly younger than patients without COVID-19, 59±13 versus 74±17 (odds ratio [95% CI], 0.94 [0.81-0.98]; P=0.004). Seventy-five percent of patients with COVID-19 were male compared with 43% of patients without COVID-19 (odds ratio [95% CI], 3.99 [1.12-14.17]; P=0.032). Patients with COVID-19 were less likely to be White (8% versus 38% [odds ratio (95% CI), 0.15 (0.04-0.81); P=0.027]). In comparison to a similar time duration before the COVID-19 outbreak, a 2-fold increase in the total number of ELVO was observed (estimate: 0.78 [95% CI, 0.47-1.08], P≤0.0001).
Conclusions:
More than half of the ELVO stroke patients during the peak time of the New York City's COVID-19 outbreak were COVID-19 positive, and those patients with COVID-19 were younger, more likely to be male, and less likely to be White. Our findings also suggest an increase in the incidence of ELVO stroke during the peak of the COVID-19 outbreak.
Related Concept Videos
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
01:30Coronary Artery Disease III: Clinical Manifestations
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
01:25Endocarditis II: Clinical Features of Infective Endocarditis
01:30Acute Coronary Syndrome III: Diagnostic Studies