Covid19 and the impact on the outocme of Ischaemic Stroke Patients

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Stroke Journal (December 2021) has published a study in which the authors have evaluated whether stroke severity, functional outcome, and mortality are different in patients with ischaemic stroke with or without coronavirus disease 2019 (COVID-19) infection. It was a prospective, observational, multicentre cohort study in Catalonia, Spain. The Recruitment was consecutive from mid-March to mid-May 2020. Patients had an acute ischaemic stroke within 48 hours and a previous modified Rankin Scale (mRS) score of 0 to 3. The researchers collected demographic data, vascular risk factors, prior mRS score, National Institutes of Health Stroke Scale score, rate of reperfusion therapies, logistics, and metrics. Primary end point was functional outcome at 3 months. Favourable outcome was defined depending on the previous mRS score. Secondary outcome was mortality at 3 months. The authors performed mRS shift and multivariable analyses.

The study evaluated 701 patients (mean age 72.3±13.3 years, 60.5% men) and 91 (13%) had COVID-19 infection. Median baseline National Institutes of Health Stroke Scale score was higher in patients with COVID-19 compared with patients without COVID-19 (8 [3–18] versus 6 [2–14], P=0.049). Proportion of patients with a favourable functional outcome was 33.7% in the COVID-19 and 47% in the non-COVID-19 group. However, after a multivariable logistic regression analysis, COVID-19 infection did not increase the probability of unfavourable functional outcome. Mortality rate was 39.3% among patients with COVID-19 and 16.1% in the non-COVID-19 group. In the multivariable logistic regression analysis, COVID-19 infection was a risk factor for mortality (hazard ratio, 3.14 [95% CI, 2.10–4.71]; P<0.001).

The study concluded that patients with ischaemic stroke and COVID-19 infection have more severe strokes and a higher mortality than patients with stroke without COVID-19 infection. However, functional outcome is comparable in both groups.

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