在COVID-19中缺血性中风:危险因素,肥胖悖论,以及触发因素和因果关系之间的区别
Francesco Janes1,2, Emanuela Sozio3, Gian Luigi Gigli2
1Clinic of Neurology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
Frontiers in neurology
|August 18, 2023
概括
在COVID-19患者中,中风的发生率为1.51%;严重的COVID-19,心房动和缺血性心脏病是关键风险因素. 肥胖似乎对这些患者的中风有保护作用.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
背景情况:
- 脑卒中是COVID-19的一个已知的并发症,但其发病率,风险因素和因果关系需要进一步阐明.
- 了解COVID-19和中风之间的关系对于患者管理和公共卫生策略至关重要.
研究的目的:
- 在住院患者中描述COVID-19相关的中风.
- 在COVID-19患者中确定缺血性中风 (IS) 的独立风险因素.
- 为了分类COVID-19在中风事件中的因果作用.
主要方法:
- 在2020年11月至2021年4月期间住院的COVID-19患者的回顾性分析.
- 缺血性中风 (IS) 的风险因素分析,占COVID-19相关中风的92%.
- 将COVID-19的因果归因归为IS事件的分类.
主要成果:
- 住院COVID-19患者中急性中风的发生率为1.51% (62/4105).
- 对IS的独立风险因素包括严重的COVID-19,心房动和缺血性心脏病.
- 肥胖 (BMI>30 kg/m2) 被确定为IS (或0.90) 的保护因素.
- 在32.1%的IS病例中,COVID-19被认为是因果因素,在28.6%的IS病例中被认为是辅因子,在39.3%的IS病例中被认为是可能的触发因素.
结论:
- 观察到的中风率与现有文献一致,验证了这些发现.
- 通过特定的临床和放射性特征,可以区分由COVID-19引起和触发的IS.
- 患者血管疾病史和风险因素对于评估COVID-19患者的IS风险至关重要,尽管可能存在肥胖悖论.
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