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Hemorrhagic and ischemic stroke in patients with coronavirus disease 2019: incidence, risk factors, and pathogenesis - a systematic review and meta-analysis

Background: In this study, we aimed to determine the global prevalence, chronological order of symptom appearance, and mortality rates with regard to hemorrhagic and ischemic stroke in patients with coronavirus disease 2019 (COVID-19) and to discuss possible pathogeneses of hemorrhagic and ischemic...

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Autores principales: Syahrul, Syahrul, Maliga, Helnida Anggun, Ilmawan, Muhammad, Fahriani, Marhami, Mamada, Sukamto S., Fajar, Jonny Karunia, Frediansyah, Andri, Syahrul, Faza Nabila, Imran, Imran, Haris, Salim, Rambe, Aldy Safruddin, Emran, Talha Bin, Rabaan, Ali A., Tiwari, Ruchi, Dhama, Kuldeep, Nainu, Firzan, Mutiawati, Endang, Harapan, Harapan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: F1000 Research Limited 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7934095/
https://www.ncbi.nlm.nih.gov/pubmed/33708378
http://dx.doi.org/10.12688/f1000research.42308.1
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author Syahrul, Syahrul
Maliga, Helnida Anggun
Ilmawan, Muhammad
Fahriani, Marhami
Mamada, Sukamto S.
Fajar, Jonny Karunia
Frediansyah, Andri
Syahrul, Faza Nabila
Imran, Imran
Haris, Salim
Rambe, Aldy Safruddin
Emran, Talha Bin
Rabaan, Ali A.
Tiwari, Ruchi
Dhama, Kuldeep
Nainu, Firzan
Mutiawati, Endang
Harapan, Harapan
author_facet Syahrul, Syahrul
Maliga, Helnida Anggun
Ilmawan, Muhammad
Fahriani, Marhami
Mamada, Sukamto S.
Fajar, Jonny Karunia
Frediansyah, Andri
Syahrul, Faza Nabila
Imran, Imran
Haris, Salim
Rambe, Aldy Safruddin
Emran, Talha Bin
Rabaan, Ali A.
Tiwari, Ruchi
Dhama, Kuldeep
Nainu, Firzan
Mutiawati, Endang
Harapan, Harapan
author_sort Syahrul, Syahrul
collection PubMed
description Background: In this study, we aimed to determine the global prevalence, chronological order of symptom appearance, and mortality rates with regard to hemorrhagic and ischemic stroke in patients with coronavirus disease 2019 (COVID-19) and to discuss possible pathogeneses of hemorrhagic and ischemic stroke in individuals with the disease. Methods: We searched the PubMed, Scopus, and Web of Science databases for relevant articles published up to November 8, 2020. Data regarding study characteristics, hemorrhagic stroke, ischemic stroke, and COVID-19 were retrieved in accordance with the PRISMA guidelines. The Newcastle-Ottawa scale was used to assess the quality of the eligible studies. The pooled prevalence and mortality rate of hemorrhagic and ischemic stroke were calculated. Results: The pooled estimate of prevalence of hemorrhagic stroke was 0.46% (95% CI 0.40%–0.53%; I (2)=89.81%) among 67,155 COVID-19 patients and that of ischemic stroke was 1.11% (95% CI 1.03%–1.22%; I (2)=94.07%) among 58,104 COVID-19 patients. Ischemic stroke was more predominant (incidence: 71.58%) than hemorrhagic stroke (incidence: 28.42%) in COVID-19 patients who experienced a stroke. In COVID-19 patients who experienced a stroke, hospital admission with respiratory symptoms was more commonly reported than that with neurological symptoms (20.83% for hemorrhagic stroke and 5.51% for ischemic stroke versus 6.94% for hemorrhagic stroke and 5.33% for ischemic stroke, respectively). The pooled mortality rate of COVID-19 patients who experienced a hemorrhagic and ischemic stroke was 44.72% (95% CI 36.73%–52.98%) and 36.23% (95% CI 30.63%–42.24%), respectively. Conclusions: Although the occurrence of hemorrhagic and ischemic stroke is low, the mortality rates of both stroke types in patients with COVID-19 are concerning, and therefore, despite several potential pathogeneses that have been proposed, studies aimed at definitively elucidating the mechanisms of hemorrhagic and ischemic stroke in individuals with COVID-19 are warranted. PROSPERO registration: CRD42020224470 (04/12/20)
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spelling pubmed-79340952021-03-10 Hemorrhagic and ischemic stroke in patients with coronavirus disease 2019: incidence, risk factors, and pathogenesis - a systematic review and meta-analysis Syahrul, Syahrul Maliga, Helnida Anggun Ilmawan, Muhammad Fahriani, Marhami Mamada, Sukamto S. Fajar, Jonny Karunia Frediansyah, Andri Syahrul, Faza Nabila Imran, Imran Haris, Salim Rambe, Aldy Safruddin Emran, Talha Bin Rabaan, Ali A. Tiwari, Ruchi Dhama, Kuldeep Nainu, Firzan Mutiawati, Endang Harapan, Harapan F1000Res Systematic Review Background: In this study, we aimed to determine the global prevalence, chronological order of symptom appearance, and mortality rates with regard to hemorrhagic and ischemic stroke in patients with coronavirus disease 2019 (COVID-19) and to discuss possible pathogeneses of hemorrhagic and ischemic stroke in individuals with the disease. Methods: We searched the PubMed, Scopus, and Web of Science databases for relevant articles published up to November 8, 2020. Data regarding study characteristics, hemorrhagic stroke, ischemic stroke, and COVID-19 were retrieved in accordance with the PRISMA guidelines. The Newcastle-Ottawa scale was used to assess the quality of the eligible studies. The pooled prevalence and mortality rate of hemorrhagic and ischemic stroke were calculated. Results: The pooled estimate of prevalence of hemorrhagic stroke was 0.46% (95% CI 0.40%–0.53%; I (2)=89.81%) among 67,155 COVID-19 patients and that of ischemic stroke was 1.11% (95% CI 1.03%–1.22%; I (2)=94.07%) among 58,104 COVID-19 patients. Ischemic stroke was more predominant (incidence: 71.58%) than hemorrhagic stroke (incidence: 28.42%) in COVID-19 patients who experienced a stroke. In COVID-19 patients who experienced a stroke, hospital admission with respiratory symptoms was more commonly reported than that with neurological symptoms (20.83% for hemorrhagic stroke and 5.51% for ischemic stroke versus 6.94% for hemorrhagic stroke and 5.33% for ischemic stroke, respectively). The pooled mortality rate of COVID-19 patients who experienced a hemorrhagic and ischemic stroke was 44.72% (95% CI 36.73%–52.98%) and 36.23% (95% CI 30.63%–42.24%), respectively. Conclusions: Although the occurrence of hemorrhagic and ischemic stroke is low, the mortality rates of both stroke types in patients with COVID-19 are concerning, and therefore, despite several potential pathogeneses that have been proposed, studies aimed at definitively elucidating the mechanisms of hemorrhagic and ischemic stroke in individuals with COVID-19 are warranted. PROSPERO registration: CRD42020224470 (04/12/20) F1000 Research Limited 2021-01-19 /pmc/articles/PMC7934095/ /pubmed/33708378 http://dx.doi.org/10.12688/f1000research.42308.1 Text en Copyright: © 2021 Syahrul S et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Systematic Review
Syahrul, Syahrul
Maliga, Helnida Anggun
Ilmawan, Muhammad
Fahriani, Marhami
Mamada, Sukamto S.
Fajar, Jonny Karunia
Frediansyah, Andri
Syahrul, Faza Nabila
Imran, Imran
Haris, Salim
Rambe, Aldy Safruddin
Emran, Talha Bin
Rabaan, Ali A.
Tiwari, Ruchi
Dhama, Kuldeep
Nainu, Firzan
Mutiawati, Endang
Harapan, Harapan
Hemorrhagic and ischemic stroke in patients with coronavirus disease 2019: incidence, risk factors, and pathogenesis - a systematic review and meta-analysis
title Hemorrhagic and ischemic stroke in patients with coronavirus disease 2019: incidence, risk factors, and pathogenesis - a systematic review and meta-analysis
title_full Hemorrhagic and ischemic stroke in patients with coronavirus disease 2019: incidence, risk factors, and pathogenesis - a systematic review and meta-analysis
title_fullStr Hemorrhagic and ischemic stroke in patients with coronavirus disease 2019: incidence, risk factors, and pathogenesis - a systematic review and meta-analysis
title_full_unstemmed Hemorrhagic and ischemic stroke in patients with coronavirus disease 2019: incidence, risk factors, and pathogenesis - a systematic review and meta-analysis
title_short Hemorrhagic and ischemic stroke in patients with coronavirus disease 2019: incidence, risk factors, and pathogenesis - a systematic review and meta-analysis
title_sort hemorrhagic and ischemic stroke in patients with coronavirus disease 2019: incidence, risk factors, and pathogenesis - a systematic review and meta-analysis
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7934095/
https://www.ncbi.nlm.nih.gov/pubmed/33708378
http://dx.doi.org/10.12688/f1000research.42308.1
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