Effect of Asymptomatic and Symptomatic COVID-19 on Acute
Ischemic Stroke Revascularization Outcomes

J 2024

Effect of Asymptomatic and Symptomatic COVID-19 on Acute Ischemic Stroke Revascularization Outcomes

STRAMBO, Davide, Joao Pedro MARTO, George NTAIOS, Thanh N NGUYEN, Patrik MICHEL et. al.

Základní údaje

Originální název

Effect of Asymptomatic and Symptomatic COVID-19 on Acute Ischemic Stroke Revascularization Outcomes

Název česky

Effect of Asymptomatic and Symptomatic COVID-19 on Acute Ischemic Stroke Revascularization Outcomes

Autoři

STRAMBO, Davide, Joao Pedro MARTO, George NTAIOS, Thanh N NGUYEN a Patrik MICHEL

Vydání

Stroke, Dallas, Lippincott Williams & Wilkins, 2024, 0039-2499

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30230 Other clinical medicine subjects

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 8.300 v roce 2022

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1161/STROKEAHA.123.043899

UT WoS

001128650000020

Klíčová slova česky

endothelial cells; ischemic stroke; renin-angiotensin system; SARS-CoV-2; thrombosis

Klíčová slova anglicky

endothelial cells; ischemic stroke; renin-angiotensin system; SARS-CoV-2; thrombosis

Štítky

Excelence Science, FN Brno, MU, RIV, user

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 16. 7. 2024 10:36, Bc. Hana Vladíková, BBA

Anotace

V originále

BACKGROUND: The association of COVID-19 with higher bleeding risk and worse outcomes in acute ischemic stroke (AIS) undergoing revascularization may be related to the presence of infection symptoms. We aimed to assess the safety and outcomes of revascularization treatments in patients with AIS with asymptomatic COVID-19 (AS-COVID) or symptomatic COVID-19 (S-COVID).METHODS: We conducted an international multicenter retrospective cohort study of consecutive AIS tested for SARS-CoV-2, receiving intravenous thrombolysis and endovascular treatment between 2020 and 2021. We compared COVID-negative controls, AS-COVID, and S-COVID using multivariable regression. We assessed symptomatic intracranial hemorrhage (symptomatic intracerebral hemorrhage), mortality, and 3-month disability (modified Rankin Scale score).RESULTS: Among 15 124 patients from 105 centers (median age, 71 years; 49% men; 39% treated with intravenous thrombolysis only; and 61% with endovascular treatment +/- intravenous thrombolysis), 849 (5.6%) had COVID-19, of whom 395 (46%) were asymptomatic and 454 (54%) symptomatic. Compared with controls, both patients with AS-COVID and S-COVID had higher symptomatic intracerebral hemorrhage rates (COVID-controls, 5%; AS-COVID, 7.6%; S-COVID, 9.4%; adjusted odds ratio [aOR], 1.43 [95% CI, 1.03-1.99]; aOR, 1.63 [95% CI, 1.14-2.32], respectively). Only in patients with symptomatic infections, we observed a significant increase in mortality at 24 hours (COVID-controls, 1.3%; S-COVID, 4.8%; aOR, 2.97 [95% CI, 1.76-5.03]) and 3 months (COVID-controls, 19.5%; S-COVID, 40%; aOR, 2.64 [95% CI, 2.06-3.37]). Patients with COVID-19 had worse 3-month disability regardless of disease symptoms although disability was affected to a greater extent in symptomatic patients (aOR for worse modified Rankin Scale score shift: AS-COVID, 1.25 [95% CI, 1.03-1.51]; S-COVID, 2.10 [95% CI, 1.75-2.53]). S-COVID had lower successful recanalization (74.9% versus 85.6%; P<0.001), first pass recanalization (20.3% versus 28.3%; P=0.005), and a higher number of passes.CONCLUSIONS: In AIS undergoing revascularization treatments, both AS-COVID and S-COVID influence the risk of intracranial bleeding and worse clinical outcomes. The magnitude of this effect is more pronounced in symptomatic infections, which also present less favorable recanalization outcomes. These findings emphasize the impact of SARS-CoV-2 infection on the prognosis of revascularized AIS independent of symptom status.

Návaznosti

90249, velká výzkumná infrastruktura

Název: CZECRIN IV

Citovat

STRAMBO, Davide, Joao Pedro MARTO, George NTAIOS, Thanh N NGUYEN a Patrik MICHEL. Effect of Asymptomatic and Symptomatic COVID-19 on Acute Ischemic Stroke Revascularization Outcomes. Stroke. Dallas: Lippincott Williams & Wilkins, 2024, roč. 55, č. 1, s. 78-88. ISSN 0039-2499. Dostupné z: https://dx.doi.org/10.1161/STROKEAHA.123.043899.

@article{2418725,
   author = {Strambo, Davide and Marto, Joao Pedro and Ntaios, George and Nguyen, Thanh N and Michel, Patrik},
   article_location = {Dallas},
   article_number = {1},
   doi = {http://dx.doi.org/10.1161/STROKEAHA.123.043899},
   keywords = {endothelial cells; ischemic stroke; renin-angiotensin system; SARS-CoV-2; thrombosis},
   language = {eng},
   issn = {0039-2499},
   journal = {Stroke},
   title = {Effect of Asymptomatic and Symptomatic COVID-19 on Acute Ischemic Stroke Revascularization Outcomes},
   url = {https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1236948/full},
   volume = {55},
   year = {2024}
}

TY  - JOUR
ID  - 2418725
AU  - Strambo, Davide - Marto, Joao Pedro - Ntaios, George - Nguyen, Thanh N - Michel, Patrik
PY  - 2024
TI  - Effect of Asymptomatic and Symptomatic COVID-19 on Acute Ischemic Stroke Revascularization Outcomes
JF  - Stroke
VL  - 55
IS  - 1
SP  - 78-88
EP  - 78-88
PB  - Lippincott Williams & Wilkins
SN  - 00392499
KW  - endothelial cells
KW  - ischemic stroke
KW  - renin-angiotensin system
KW  - SARS-CoV-2
KW  - thrombosis
UR  - https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1236948/full
N2  - BACKGROUND: The association of COVID-19 with higher bleeding risk and worse outcomes in acute ischemic stroke (AIS) undergoing revascularization may be related to the presence of infection symptoms. We aimed to assess the safety and outcomes of revascularization treatments in patients with AIS with asymptomatic COVID-19 (AS-COVID) or symptomatic COVID-19 (S-COVID).METHODS: We conducted an international multicenter retrospective cohort study of consecutive AIS tested for SARS-CoV-2, receiving intravenous thrombolysis and endovascular treatment between 2020 and 2021. We compared COVID-negative controls, AS-COVID, and S-COVID using multivariable regression. We assessed symptomatic intracranial hemorrhage (symptomatic intracerebral hemorrhage), mortality, and 3-month disability (modified Rankin Scale score).RESULTS: Among 15 124 patients from 105 centers (median age, 71 years; 49% men; 39% treated with intravenous thrombolysis only; and 61% with endovascular treatment +/- intravenous thrombolysis), 849 (5.6%) had COVID-19, of whom 395 (46%) were asymptomatic and 454 (54%) symptomatic. Compared with controls, both patients with AS-COVID and S-COVID had higher symptomatic intracerebral hemorrhage rates (COVID-controls, 5%; AS-COVID, 7.6%; S-COVID, 9.4%; adjusted odds ratio [aOR], 1.43 [95% CI, 1.03-1.99]; aOR, 1.63 [95% CI, 1.14-2.32], respectively). Only in patients with symptomatic infections, we observed a significant increase in mortality at 24 hours (COVID-controls, 1.3%; S-COVID, 4.8%; aOR, 2.97 [95% CI, 1.76-5.03]) and 3 months (COVID-controls, 19.5%; S-COVID, 40%; aOR, 2.64 [95% CI, 2.06-3.37]). Patients with COVID-19 had worse 3-month disability regardless of disease symptoms although disability was affected to a greater extent in symptomatic patients (aOR for worse modified Rankin Scale score shift: AS-COVID, 1.25 [95% CI, 1.03-1.51]; S-COVID, 2.10 [95% CI, 1.75-2.53]). S-COVID had lower successful recanalization (74.9% versus 85.6%; P<0.001), first pass recanalization (20.3% versus 28.3%; P=0.005), and a higher number of passes.CONCLUSIONS: In AIS undergoing revascularization treatments, both AS-COVID and S-COVID influence the risk of intracranial bleeding and worse clinical outcomes. The magnitude of this effect is more pronounced in symptomatic infections, which also present less favorable recanalization outcomes. These findings emphasize the impact of SARS-CoV-2 infection on the prognosis of revascularized AIS independent of symptom status.
ER  -

STRAMBO, Davide, Joao Pedro MARTO, George NTAIOS, Thanh N NGUYEN a Patrik MICHEL. Effect of Asymptomatic and Symptomatic COVID-19 on Acute Ischemic Stroke Revascularization Outcomes. \textit{Stroke}. Dallas: Lippincott Williams \&{} Wilkins, 2024, roč.~55, č.~1, s.~78-88. ISSN~0039-2499. Dostupné z: https://dx.doi.org/10.1161/STROKEAHA.123.043899.

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