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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
The Effects of COVID-19 on Patients with Acute Ischemic and Hemorrhagic Stroke
Hesamodin Ashrafian Amiri1, Athena Sharifi Razavi2, Nasim Tabrizi2
1Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Mazandaran, Iran.
Insights
COVID-19 significantly worsens outcomes for stroke patients, leading to increased disability, hospital complications, and mortality. This highlights the critical impact of coronavirus infection on cerebrovascular event recovery.
Area of Science:
- Neurology
- Infectious Diseases
- Public Health
Background:
- Stroke, encompassing ischemic and hemorrhagic types, presents a significant global health challenge.
- The emergence of COVID-19 has raised concerns about its impact on various pre-existing medical conditions.
- Understanding the interplay between COVID-19 and stroke is crucial for patient management and outcomes.
Purpose of the Study:
- To investigate the effect of COVID-19 on the clinical outcomes of patients diagnosed with acute ischemic or hemorrhagic stroke.
- To compare stroke-related disability, hospital duration, intensive care unit (ICU) admission rates, and mortality between COVID-19 positive and negative stroke patients.
Main Methods:
- A retrospective study analyzing adult patients (>18 years) admitted with stroke (ischemic or hemorrhagic) between February 2019 and August 2020.
- Patients were categorized based on COVID-19 status, confirmed by RT-PCR or CT scan.
- Primary outcome: stroke-related disability (modified Rankin Scale - mRS). Secondary outcomes: hospital duration, ICU admission, and mortality.
Main Results:
- Out of 151 patients, 42 had COVID-19. COVID-19 positive patients exhibited higher baseline and discharge mRS scores, indicating greater disability.
- Stroke patients with COVID-19 required higher ICU admission rates and experienced longer hospitalizations.
- Mortality was significantly higher in the COVID-19 positive group (19 vs 13). Male sex, COVID-19, and ICU admission were independent risk factors for death.
Conclusions:
- COVID-19 infection is associated with poorer outcomes in patients with acute ischemic or hemorrhagic stroke.
- Patients with stroke and COVID-19 face increased hospital complications, including severe disability and higher mortality rates.
- These findings underscore the importance of considering COVID-19 status in the management of stroke patients.
Objective:
The objective of this study was to evaluate how COVID-19 affects patients with acute ischemic or hemorrhagic stroke outcome.
Materials And Methods:
This retrospective study was performed on adult patients (> 18 years old) with stroke (ischemic or hemorrhagic) who were admitted to hospital with or without COVID-19. The primary outcome was stroke-related disability, which was measured by mRS at baseline and discharge. Hospital duration, intensive care unit (ICU) admission, and mortality were considered the secondary outcomes.
Results:
From February 2019 until August 2020, we recruited and analyzed 151 patients, 42 of whom had COVID-19 based on RT-PCR tests or lung CT scan findings. COVID-19 positive patients had higher baseline and final mRS scores than the control group (4.46 ± 0.67 vs 4.79 ± 0.61, P: 0.001, 3.83 ± 1.22 vs 4.46 ± 0.67, P: 0.001). Moreover, stroke patients with COVID-19 experienced a more severe disease and required a higher rate of ICU admission (17 vs 0, P:0.001) and longer hospitalization compared to those without COVID-19 (8.50 ± 7.86 vs 7.5 ± 11.20, P: 0.021). Also, mortality was higher in the COVID-19 group (19 vs 13, P:0.001). There was not any significant differences between the two groups in terms of the involvement of cerebral arteries and type of stroke. Male sex, COVID-19, and ICU admission were the main independent risk factors for death.
Conclusion:
The results of the study showed stroke patients (ischemic or hemorrhagic) with COVID-19 can have more disabilities and incur more hospital complications and mortality than non-COVID-19 patients.
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