1. Stroke etiologies in patients with COVID-19: the SVIN COVID-19 multinational registry.
- Author
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Ramos-Araque, María E., Siegler, James E., Ribo, Marc, Requena, Manuel, López, Cristina, de Lera, Mercedes, Arenillas, Juan F., Pérez, Isabel Hernández, Gómez-Vicente, Beatriz, Talavera, Blanca, Portela, Pere Cardona, Guillen, Ana Nuñez, Urra, Xabier, Llull, Laura, Renú, Arturo, Nguyen, Thanh N., Jillella, Dinesh, Nahab, Fadi, Nogueira, Raul, and Haussen, Diogo
- Subjects
COVID-19 ,STROKE patients ,LEUKOCYTE count ,HOSPITAL mortality - Abstract
Background and Purpose: Coronavirus disease 2019 (COVID-19) is associated with a small but clinically significant risk of stroke, the cause of which is frequently cryptogenic. In a large multinational cohort of consecutive COVID-19 patients with stroke, we evaluated clinical predictors of cryptogenic stroke, short-term functional outcomes and in-hospital mortality among patients according to stroke etiology.Methods: We explored clinical characteristics and short-term outcomes of consecutively evaluated patients 18 years of age or older with acute ischemic stroke (AIS) and laboratory-confirmed COVID-19 from 31 hospitals in 4 countries (3/1/20-6/16/20).Results: Of the 14.483 laboratory-confirmed patients with COVID-19, 156 (1.1%) were diagnosed with AIS. Sixty-one (39.4%) were female, 84 (67.2%) white, and 88 (61.5%) were between 60 and 79 years of age. The most frequently reported etiology of AIS was cryptogenic (55/129, 42.6%), which was associated with significantly higher white blood cell count, c-reactive protein, and D-dimer levels than non-cryptogenic AIS patients (p=0.05 for all comparisons). In a multivariable backward stepwise regression model estimating the odds of in-hospital mortality, cryptogenic stroke mechanism was associated with a fivefold greater odds in-hospital mortality than strokes due to any other mechanism (adjusted OR 5.16, 95%CI 1.41-18.87, p = 0.01). In that model, older age (aOR 2.05 per decade, 95%CI 1.35-3.11, p < 0.01) and higher baseline NIHSS (aOR 1.12, 95%CI 1.02-1.21, p = 0.01) were also independently predictive of mortality.Conclusions: Our findings suggest that cryptogenic stroke among COVID-19 patients carries a significant risk of early mortality. [ABSTRACT FROM AUTHOR]- Published
- 2021
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