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Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study
(1) Background: Acute ischemic stroke (AIS) is a possible complication of the coronavirus disease 2019 (COVID-19). Safety and efficacy data on reperfusion therapies (RT)—intravenous thrombolysis and endovascular treatment (EVT)—in stroke patients with COVID-19 is lacking. (2) Methods: We performed a...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9181080/ https://www.ncbi.nlm.nih.gov/pubmed/35683393 http://dx.doi.org/10.3390/jcm11113004 |
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author | Jurkevičienė, Justina Vaišvilas, Mantas Masiliūnas, Rytis Matijošaitis, Vaidas Vaitkus, Antanas Geštautaitė, Dovilė Taroza, Saulius Puzinas, Paulius Galvanauskaitė, Erika Jatužis, Dalius Vilionskis, Aleksandras |
author_facet | Jurkevičienė, Justina Vaišvilas, Mantas Masiliūnas, Rytis Matijošaitis, Vaidas Vaitkus, Antanas Geštautaitė, Dovilė Taroza, Saulius Puzinas, Paulius Galvanauskaitė, Erika Jatužis, Dalius Vilionskis, Aleksandras |
author_sort | Jurkevičienė, Justina |
collection | PubMed |
description | (1) Background: Acute ischemic stroke (AIS) is a possible complication of the coronavirus disease 2019 (COVID-19). Safety and efficacy data on reperfusion therapies (RT)—intravenous thrombolysis and endovascular treatment (EVT)—in stroke patients with COVID-19 is lacking. (2) Methods: We performed a retrospective nationwide multi-center pair-matched analysis of COVID-19 patients with AIS who underwent RT. We included adult COVID-19 patients with AIS who were treated with RT between 16 March 2020 and 30 June 2021. All subjects were paired with non-infected controls, matched for age, sex, stroke arterial vascular territory, and RT modality. The primary outcome measure was a favorable functional outcome defined by the modified Rankin scale (mRS 0–2). (3) Results: Thirty-one subjects and thirty-one matched controls were included. The median baseline National Institutes of Health Stroke Scale (NIHSS) score was higher in the COVID-19 group (16 vs. 12, p = 0.028). Rates of ischemic changes and symptomatic intracerebral hemorrhages did not differ significantly between the two groups at 24 h after RT. The median NIHSS 24 h after reperfusion remained significantly higher in the COVID-19 group (16 vs. 5, p = 0.003). MRS 0–2 at discharge was significantly less common in COVID-19 patients (22.6% vs. 51.8%, p = 0.018). Three-month mortality was 54.8% in the COVID-19 group versus 12.9% in controls (p = 0.001). (4) Conclusion: Reperfusion therapies on AIS in COVID-19 patients appear to be safe; however, functional outcomes are significantly worse, and 3-month mortality is higher. |
format | Online Article Text |
id | pubmed-9181080 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-91810802022-06-10 Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study Jurkevičienė, Justina Vaišvilas, Mantas Masiliūnas, Rytis Matijošaitis, Vaidas Vaitkus, Antanas Geštautaitė, Dovilė Taroza, Saulius Puzinas, Paulius Galvanauskaitė, Erika Jatužis, Dalius Vilionskis, Aleksandras J Clin Med Article (1) Background: Acute ischemic stroke (AIS) is a possible complication of the coronavirus disease 2019 (COVID-19). Safety and efficacy data on reperfusion therapies (RT)—intravenous thrombolysis and endovascular treatment (EVT)—in stroke patients with COVID-19 is lacking. (2) Methods: We performed a retrospective nationwide multi-center pair-matched analysis of COVID-19 patients with AIS who underwent RT. We included adult COVID-19 patients with AIS who were treated with RT between 16 March 2020 and 30 June 2021. All subjects were paired with non-infected controls, matched for age, sex, stroke arterial vascular territory, and RT modality. The primary outcome measure was a favorable functional outcome defined by the modified Rankin scale (mRS 0–2). (3) Results: Thirty-one subjects and thirty-one matched controls were included. The median baseline National Institutes of Health Stroke Scale (NIHSS) score was higher in the COVID-19 group (16 vs. 12, p = 0.028). Rates of ischemic changes and symptomatic intracerebral hemorrhages did not differ significantly between the two groups at 24 h after RT. The median NIHSS 24 h after reperfusion remained significantly higher in the COVID-19 group (16 vs. 5, p = 0.003). MRS 0–2 at discharge was significantly less common in COVID-19 patients (22.6% vs. 51.8%, p = 0.018). Three-month mortality was 54.8% in the COVID-19 group versus 12.9% in controls (p = 0.001). (4) Conclusion: Reperfusion therapies on AIS in COVID-19 patients appear to be safe; however, functional outcomes are significantly worse, and 3-month mortality is higher. MDPI 2022-05-26 /pmc/articles/PMC9181080/ /pubmed/35683393 http://dx.doi.org/10.3390/jcm11113004 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Jurkevičienė, Justina Vaišvilas, Mantas Masiliūnas, Rytis Matijošaitis, Vaidas Vaitkus, Antanas Geštautaitė, Dovilė Taroza, Saulius Puzinas, Paulius Galvanauskaitė, Erika Jatužis, Dalius Vilionskis, Aleksandras Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study |
title | Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study |
title_full | Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study |
title_fullStr | Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study |
title_full_unstemmed | Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study |
title_short | Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study |
title_sort | reperfusion therapies for acute ischemic stroke in covid-19 patients: a nationwide multi-center study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9181080/ https://www.ncbi.nlm.nih.gov/pubmed/35683393 http://dx.doi.org/10.3390/jcm11113004 |
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