Background: The infectious disease phenotype of acute stroke associated with COVID-19 has been poorly characterized. Objective: We investigated the neurovascular and infectious disease phenotype of stroke patients with and without COVID-19 infection, and their effect on in-hospital mortality. Methods: This is a retrospective cohort study of consecutive patients with acute stroke, admitted to any ward of a hub hospital for stroke in Lombardy, Italy, during the first wave of COVID-19. Demographic, neurovascular, infectious disease, and respiratory characteristics were collected. The effect of clinical variables on survival was evaluated using logistic regression models. Results: One hundred thirty-seven patients with acute stroke were recruited; 30 (21.9%) patients had COVID-19 and represented 2.5% of the 1218 COVID-19 patients hospitalized in the study period. Demographics, comorbidities, stroke type, stroke severity, and etiology did not differ between COVID + stroke patients and non-COVID stroke patients, except for an excess of multi-embolic ischemic stroke in the COVID + group. Most COVID + stroke patients had symptomatic infection (60%) and interstitial pneumonia (70%). COVID + stroke patients required more frequently respiratory support (77% versus 29%; p < 0.0001) and had higher in-hospital mortality (40% versus 12%; p = 0.0005) than non-COVID stroke patients. Mortality was independently associated with symptomatic interstitial pneumonia (aOR 6.7; 95% CI 2.0–22.5; p = 0.002) and, to a lesser extent, with NIHSS on admission (aOR 1.1; 95% CI 1.03–1.2; p = 0.007) and recanalization therapies (aOR 0.2; 95% CI 0.04–0.98; p = 0.046). Conclusion: Symptomatic interstitial pneumonia was the major driver of in-hospital mortality in COVID + stroke patients.

Beretta, S., Iannuzzi, F., Diamanti, S., Bianchi, E., D'Urbano, L., Elisa, C., et al. (2022). Neurovascular and infectious disease phenotype of acute stroke patients with and without COVID-19. NEUROLOGICAL SCIENCES, 43(8), 4619-4625 [10.1007/s10072-022-06133-5].

Neurovascular and infectious disease phenotype of acute stroke patients with and without COVID-19

Beretta, S
;
Diamanti, S;Bonfanti, P;Ferrarese, C
2022

Abstract

Background: The infectious disease phenotype of acute stroke associated with COVID-19 has been poorly characterized. Objective: We investigated the neurovascular and infectious disease phenotype of stroke patients with and without COVID-19 infection, and their effect on in-hospital mortality. Methods: This is a retrospective cohort study of consecutive patients with acute stroke, admitted to any ward of a hub hospital for stroke in Lombardy, Italy, during the first wave of COVID-19. Demographic, neurovascular, infectious disease, and respiratory characteristics were collected. The effect of clinical variables on survival was evaluated using logistic regression models. Results: One hundred thirty-seven patients with acute stroke were recruited; 30 (21.9%) patients had COVID-19 and represented 2.5% of the 1218 COVID-19 patients hospitalized in the study period. Demographics, comorbidities, stroke type, stroke severity, and etiology did not differ between COVID + stroke patients and non-COVID stroke patients, except for an excess of multi-embolic ischemic stroke in the COVID + group. Most COVID + stroke patients had symptomatic infection (60%) and interstitial pneumonia (70%). COVID + stroke patients required more frequently respiratory support (77% versus 29%; p < 0.0001) and had higher in-hospital mortality (40% versus 12%; p = 0.0005) than non-COVID stroke patients. Mortality was independently associated with symptomatic interstitial pneumonia (aOR 6.7; 95% CI 2.0–22.5; p = 0.002) and, to a lesser extent, with NIHSS on admission (aOR 1.1; 95% CI 1.03–1.2; p = 0.007) and recanalization therapies (aOR 0.2; 95% CI 0.04–0.98; p = 0.046). Conclusion: Symptomatic interstitial pneumonia was the major driver of in-hospital mortality in COVID + stroke patients.
Articolo in rivista - Review Essay
Acute stroke; COVID-19; In-hospital mortality; Infectious disease and stroke; Pneumonia;
English
23-mag-2022
2022
43
8
4619
4625
none
Beretta, S., Iannuzzi, F., Diamanti, S., Bianchi, E., D'Urbano, L., Elisa, C., et al. (2022). Neurovascular and infectious disease phenotype of acute stroke patients with and without COVID-19. NEUROLOGICAL SCIENCES, 43(8), 4619-4625 [10.1007/s10072-022-06133-5].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/476513
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