Comparison of radiological and clinical characteristics of COVID-19 positive and negative ischemic stroke patients undergoing revascularization: A single-centre Turkish study.

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  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: Netherlands NLM ID: 7502039 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-6968 (Electronic) Linking ISSN: 03038467 NLM ISO Abbreviation: Clin Neurol Neurosurg Subsets: MEDLINE
    • Publication Information:
      Publication: Amsterdam : Elsevier
      Original Publication: Assen, Van Gorcum.
    • Subject Terms:
      COVID-19*/complications ; COVID-19*/diagnostic imaging ; Ischemic Stroke*/diagnostic imaging ; Ischemic Stroke*/surgery ; Cerebral Revascularization*/methods; Humans ; Male ; Female ; Aged ; Middle Aged ; Retrospective Studies ; Turkey/epidemiology ; Endovascular Procedures/methods ; Thrombolytic Therapy ; Aged, 80 and over ; Treatment Outcome
    • Abstract:
      Objective: We aimed to compare the radiological and clinical characteristics of COVID-19-positive and -negative acute ischemic stroke (AIS) patients who underwent revascularization and to evaluate whether COVID-19 has an effect on revascularization and outcome in AIS patients with COVID-19 infection.
      Methods: Consecutive COVID-19 positive and negative AIS patients who underwent intravenous thrombolysis and/or endovascular therapy in our hospital between March 2020 and February 2022 were included in this study. Our study is retrospective and 23 COVID-19 positive patients and 108 COVID-19 negative patients were compared in terms of radiological and clinical characteristics.
      Results: Hypertension was lower in the COVID-19 positive ischemic stroke group (p=0.029). Admission NIHSS score was higher in COVID-19 positive patients (p=0.041). ASPECTS was found to be lower in COVID-19 positive ischemic stroke patients (p=0.019). The rate of hyperdense artery sign differed between groups (p=0.014) and was higher in the COVID-19 positive ischemic stroke group. The incidence of multi-vessel occlusion was found to be significantly higher in the COVID-19-positive ischemic stroke group (p=0.002). In terms of prognostic features, only the 3-month good outcome rate was statistically significantly lower in the COVID-19-positive ischemic stroke group (p=0.011).
      Conclusion: This study found that radiologically, COVID-19 may be associated with lower ASPECTS in ischemic stroke patients receiving revascularization treatment and may predispose to multivessel occlusion and hyperdense artery sign. Clinically, COVID-19 may be associated with a more severe initial presentation and worse prognosis at 3 months in ischemic stroke patients undergoing revascularization, but may not affect long-term mortality.
      Competing Interests: Declaration of Competing Interest None.
      (Copyright © 2024 Elsevier B.V. All rights reserved.)
    • Contributed Indexing:
      Keywords: COVID-19; Ischemic stroke; Mortality; Thrombectomy; Thrombolytic therapy
    • Publication Date:
      Date Created: 20240515 Date Completed: 20240614 Latest Revision: 20240620
    • Publication Date:
      20240620
    • Accession Number:
      10.1016/j.clineuro.2024.108324
    • Accession Number:
      38749359