Characteristics of a COVID-19 Cohort With Large Vessel Occlusion: A Multicenter International Study. Issue 6 (7th June 2022)

• Record Type: Journal Article
• Authors: Jabbour, Pascal; Dmytriw, Adam A.; Sweid, Ahmad; Piotin, Michel; Bekelis, Kimon; Sourour, Nader; Raz, Eytan; Linfante, Italo; Dabus, Guilherme; Kole, Max; Martínez-Galdámez, Mario; Nimjee, Shahid M.; Lopes, Demetrius K.; Hassan, Ameer E.; Kan, Peter; Ghorbani, Mohammad; Levitt, Michael R.; Escalard, Simon; Missios, Symeon; Shapiro, Maksim; Clarençon, Frédéric; Elhorany, Mahmoud; Vela-Duarte, Daniel; Tahir, Rizwan A.; Youssef, Patrick P.; Pandey, Aditya S.; Starke, Robert M.; El Naamani, Kareem; Abbas, Rawad; Hammoud, Bassel; Mansour, Ossama Y.; Galvan, Jorge; Billingsley, Joshua T.; Mortazavi, Abolghasem; Walker, Melanie; Dibas, Mahmoud; Settecase, Fabio; Heran, Manraj K. S.; Kuhn, Anna L.; Puri, Ajit S.; Menon, Bijoy K.; Sivakumar, Sanjeev; Mowla, Ashkan; D'Amato, Salvatore; Zha, Alicia M.; Cooke, Daniel; Goyal, Mayank; Wu, Hannah; Cohen, Jake; Turkel-Parrella, David; Xavier, Andrew; Waqas, Muhammad; Tutino, Vincent M.; Siddiqui, Adnan; Gupta, Gaurav; Nanda, Anil; Khandelwal, Priyank; Tiu, Cristina; Portela, Pere C.; Perez de la Ossa, Natalia; Urra, Xabier; de Lera, Mercedes; Arenillas, Juan F.; Ribo, Marc; Requena, Manuel; Piano, Mariangela; Pero, Guglielmo; De Sousa, Keith; Al-Mufti, Fawaz; Hashim, Zafar; Nayak, Sanjeev; Renieri, Leonardo; Aziz-Sultan, Mohamed A.; Nguyen, Thanh N.; Feineigle, Patricia; Patel, Aman B.; Siegler, James E.; Badih, Khodr; Grossberg, Jonathan A.; Saad, Hassan; Gooch, M. Reid; Herial, Nabeel A.; Rosenwasser, Robert H.; Tjoumakaris, Stavropoula; Tiwari, Ambooj;
• Is Part Of: Neurosurgery. Volume 90:Issue 6(2022)
• Page Start: 725
• Page End: 733
• Publication Date: 2022-06-07
• Subjects: COVID-19 -- SARS-CoV-2 -- Central nervous system -- Cerebrovascular disease -- Hypercoagulable; Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1227/neu.0000000000001902
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract : BACKGROUND: The mechanisms and outcomes in coronavirus disease (COVID-19)–associated stroke are unique from those of non–COVID-19 stroke. OBJECTIVE: To describe the efficacy and outcomes of acute revascularization of large vessel occlusion (LVO) in the setting of COVID-19 in an international cohort. METHODS: We conducted an international multicenter retrospective study of consecutively admitted patients with COVID-19 with concomitant acute LVO across 50 comprehensive stroke centers. Our control group constituted historical controls of patients presenting with LVO and receiving a mechanical thrombectomy between January 2018 and December 2020. RESULTS: The total cohort was 575 patients with acute LVO; 194 patients had COVID-19 while 381 patients did not. Patients in the COVID-19 group were younger (62.5 vs 71.2; P < .001) and lacked vascular risk factors (49, 25.3% vs 54, 14.2%; P = .001). Modified thrombolysis in cerebral infarction 3 revascularization was less common in the COVID-19 group (74, 39.2% vs 252, 67.2%; P < .001). Poor functional outcome at discharge (defined as modified Ranklin Scale 3-6) was more common in the COVID-19 group (150, 79.8% vs 132, 66.7%; P = .004). COVID-19 was independently associated with a lower likelihood of achieving modified thrombolysis in cerebral infarction 3 (odds ratio [OR]: 0.4, 95% CI: 0.2-0.7; P < .001) and unfavorable outcomes (OR: 2.5, 95% CI: 1.4-4.5; P = .002). CONCLUSION: COVID-19 was an independent predictor of incomplete revascularization and poor outcomes in patients with stroke due to LVO. Patients with COVID-19 with LVO were younger, had fewer cerebrovascular risk factors, and suffered from higher morbidity/mortality rates. Abstract :