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...
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| Veröffentlicht in: | Journal of clinical medicine 2022-05, Vol.11 (11), p.3004 |
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| creator | Jurkevičienė, Justina Vaišvilas, Mantas Masiliūnas, Rytis Matijošaitis, Vaidas Vaitkus, Antanas Geštautaitė, Dovilė Taroza, Saulius Puzinas, Paulius Galvanauskaitė, Erika Jatužis, Dalius Vilionskis, Aleksandras |
| 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,
= 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,
= 0.003). MRS 0-2 at discharge was significantly less common in COVID-19 patients (22.6% vs. 51.8%,
= 0.018). Three-month mortality was 54.8% in the COVID-19 group versus 12.9% in controls (
= 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. |
| doi_str_mv | 10.3390/jcm11113004 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9181080</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2675615055</sourcerecordid><originalsourceid>FETCH-LOGICAL-c339t-9b934195990fc04320e007b6b123e59e950f9529652e86a012f83329de9766593</originalsourceid><addsrcrecordid>eNpdkdFrFDEQxoNUbDnvyfcS8KUgWyfJJtn0oXCcbT2oVrT6GvZys72cu5trsqv0vzdHazmdlxmY33x8w0fIGwanQhh4v3EdyyUAyhfkiIPWBYhKHOzNh2Sa0gZyVVXJmX5FDoVUVT4XRwS_4hZjMyYfenq7xlhvPSbahEhnbhyQLpJbY-cd_TbE8BOp7-n85sfiQ8EM_VIPHvshndEZ_Zzn0P_2K6SfxnbwxTxvMOazcfXwmrxs6jbh9KlPyPfLi9v5x-L65moxn10XLrsZCrM0omRGGgONg1JwQAC9VEvGBUqDRkJjJDdKcqxUDYw3-Q1uVmi0UtKICTl_1N2Oyw5XLluIdWu30Xd1fLCh9vbfTe_X9i78soZVDCrIAidPAjHcj5gG2_nksG3rHsOYLFdaKiZByoy-_Q_dhDH2-b0dVQqlldaZevdIuRhSitg8m2FgdwnavQQzfbzv_5n9m5f4A9SXlAI</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2674367677</pqid></control><display><type>article</type><title>Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study</title><source>MDPI - Multidisciplinary Digital Publishing Institute</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>PubMed Central Open Access</source><creator>Jurkevičienė, Justina ; Vaišvilas, Mantas ; Masiliūnas, Rytis ; Matijošaitis, Vaidas ; Vaitkus, Antanas ; Geštautaitė, Dovilė ; Taroza, Saulius ; Puzinas, Paulius ; Galvanauskaitė, Erika ; Jatužis, Dalius ; Vilionskis, Aleksandras</creator><creatorcontrib>Jurkevičienė, Justina ; Vaišvilas, Mantas ; Masiliūnas, Rytis ; Matijošaitis, Vaidas ; Vaitkus, Antanas ; Geštautaitė, Dovilė ; Taroza, Saulius ; Puzinas, Paulius ; Galvanauskaitė, Erika ; Jatužis, Dalius ; Vilionskis, Aleksandras</creatorcontrib><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,
= 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,
= 0.003). MRS 0-2 at discharge was significantly less common in COVID-19 patients (22.6% vs. 51.8%,
= 0.018). Three-month mortality was 54.8% in the COVID-19 group versus 12.9% in controls (
= 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.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm11113004</identifier><identifier>PMID: 35683393</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Blood pressure ; Body temperature ; Clinical medicine ; Coronaviruses ; COVID-19 ; Edema ; Hemorrhage ; Laboratories ; Medical imaging ; Mortality ; Pandemics ; Patients ; Pneumonia ; Risk factors ; Severe acute respiratory syndrome coronavirus 2 ; Statistical analysis ; Stroke ; Tomography ; Urinary tract diseases ; Urinary tract infections ; Urogenital system</subject><ispartof>Journal of clinical medicine, 2022-05, Vol.11 (11), p.3004</ispartof><rights>2022 by the authors. 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/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 by the authors. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c339t-9b934195990fc04320e007b6b123e59e950f9529652e86a012f83329de9766593</citedby><cites>FETCH-LOGICAL-c339t-9b934195990fc04320e007b6b123e59e950f9529652e86a012f83329de9766593</cites><orcidid>0000-0002-9067-7810 ; 0000-0002-8055-3558 ; 0000-0002-0746-1745 ; 0000-0002-8033-9682 ; 0000-0001-6159-4795</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9181080/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9181080/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35683393$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jurkevičienė, Justina</creatorcontrib><creatorcontrib>Vaišvilas, Mantas</creatorcontrib><creatorcontrib>Masiliūnas, Rytis</creatorcontrib><creatorcontrib>Matijošaitis, Vaidas</creatorcontrib><creatorcontrib>Vaitkus, Antanas</creatorcontrib><creatorcontrib>Geštautaitė, Dovilė</creatorcontrib><creatorcontrib>Taroza, Saulius</creatorcontrib><creatorcontrib>Puzinas, Paulius</creatorcontrib><creatorcontrib>Galvanauskaitė, Erika</creatorcontrib><creatorcontrib>Jatužis, Dalius</creatorcontrib><creatorcontrib>Vilionskis, Aleksandras</creatorcontrib><title>Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><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,
= 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,
= 0.003). MRS 0-2 at discharge was significantly less common in COVID-19 patients (22.6% vs. 51.8%,
= 0.018). Three-month mortality was 54.8% in the COVID-19 group versus 12.9% in controls (
= 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.</description><subject>Blood pressure</subject><subject>Body temperature</subject><subject>Clinical medicine</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Edema</subject><subject>Hemorrhage</subject><subject>Laboratories</subject><subject>Medical imaging</subject><subject>Mortality</subject><subject>Pandemics</subject><subject>Patients</subject><subject>Pneumonia</subject><subject>Risk factors</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Statistical analysis</subject><subject>Stroke</subject><subject>Tomography</subject><subject>Urinary tract diseases</subject><subject>Urinary tract infections</subject><subject>Urogenital system</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNpdkdFrFDEQxoNUbDnvyfcS8KUgWyfJJtn0oXCcbT2oVrT6GvZys72cu5trsqv0vzdHazmdlxmY33x8w0fIGwanQhh4v3EdyyUAyhfkiIPWBYhKHOzNh2Sa0gZyVVXJmX5FDoVUVT4XRwS_4hZjMyYfenq7xlhvPSbahEhnbhyQLpJbY-cd_TbE8BOp7-n85sfiQ8EM_VIPHvshndEZ_Zzn0P_2K6SfxnbwxTxvMOazcfXwmrxs6jbh9KlPyPfLi9v5x-L65moxn10XLrsZCrM0omRGGgONg1JwQAC9VEvGBUqDRkJjJDdKcqxUDYw3-Q1uVmi0UtKICTl_1N2Oyw5XLluIdWu30Xd1fLCh9vbfTe_X9i78soZVDCrIAidPAjHcj5gG2_nksG3rHsOYLFdaKiZByoy-_Q_dhDH2-b0dVQqlldaZevdIuRhSitg8m2FgdwnavQQzfbzv_5n9m5f4A9SXlAI</recordid><startdate>20220526</startdate><enddate>20220526</enddate><creator>Jurkevičienė, Justina</creator><creator>Vaišvilas, Mantas</creator><creator>Masiliūnas, Rytis</creator><creator>Matijošaitis, Vaidas</creator><creator>Vaitkus, Antanas</creator><creator>Geštautaitė, Dovilė</creator><creator>Taroza, Saulius</creator><creator>Puzinas, Paulius</creator><creator>Galvanauskaitė, Erika</creator><creator>Jatužis, Dalius</creator><creator>Vilionskis, Aleksandras</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-9067-7810</orcidid><orcidid>https://orcid.org/0000-0002-8055-3558</orcidid><orcidid>https://orcid.org/0000-0002-0746-1745</orcidid><orcidid>https://orcid.org/0000-0002-8033-9682</orcidid><orcidid>https://orcid.org/0000-0001-6159-4795</orcidid></search><sort><creationdate>20220526</creationdate><title>Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study</title><author>Jurkevičienė, Justina ; 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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,
= 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,
= 0.003). MRS 0-2 at discharge was significantly less common in COVID-19 patients (22.6% vs. 51.8%,
= 0.018). Three-month mortality was 54.8% in the COVID-19 group versus 12.9% in controls (
= 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.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>35683393</pmid><doi>10.3390/jcm11113004</doi><orcidid>https://orcid.org/0000-0002-9067-7810</orcidid><orcidid>https://orcid.org/0000-0002-8055-3558</orcidid><orcidid>https://orcid.org/0000-0002-0746-1745</orcidid><orcidid>https://orcid.org/0000-0002-8033-9682</orcidid><orcidid>https://orcid.org/0000-0001-6159-4795</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of clinical medicine, 2022-05, Vol.11 (11), p.3004 |
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| source | MDPI - Multidisciplinary Digital Publishing Institute; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access |
| subjects | Blood pressure Body temperature Clinical medicine Coronaviruses COVID-19 Edema Hemorrhage Laboratories Medical imaging Mortality Pandemics Patients Pneumonia Risk factors Severe acute respiratory syndrome coronavirus 2 Statistical analysis Stroke Tomography Urinary tract diseases Urinary tract infections Urogenital system |
| title | Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study |
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