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The Impact of SARS‐CoV ‐2 on Stroke Epidemiology and Care: A Meta‐Analysis
- Source :
- Annals of Neurology, Annals of Neurology, Wiley, 2021, 89 (2), pp.380-388. ⟨10.1002/ana.25967⟩, Annals of Neurology, 2021, 89 (2), pp.380-388. ⟨10.1002/ana.25967⟩
- Publication Year :
- 2021
- Publisher :
- HAL CCSD, 2021.
-
Abstract
- International audience; Objective: Emerging data indicate an increased risk of cerebrovascular events with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and highlight the potential impact of coronavirus disease (COVID-19) on the management and outcomes of acute stroke. We conducted a systematic review and meta-analysis to evaluate the aforementioned considerations.Methods: We performed a meta-analysis of observational cohort studies reporting on the occurrence and/or outcomes of patients with cerebrovascular events in association with their SARS-CoV-2 infection status. We used a random-effects model. Summary estimates were reported as odds ratios (ORs) and corresponding 95% confidence intervals (CIs).Results: We identified 18 cohort studies including 67,845 patients. Among patients with SARS-CoV-2, 1.3% (95% CI = 0.9-1.6%, I2 = 87%) were hospitalized for cerebrovascular events, 1.1% (95% CI = 0.8-1.3%, I2 = 85%) for ischemic stroke, and 0.2% (95% CI = 0.1-0.3%, I2 = 64%) for hemorrhagic stroke. Compared to noninfected contemporary or historical controls, patients with SARS-CoV-2 infection had increased odds of ischemic stroke (OR = 3.58, 95% CI = 1.43-8.92, I2 = 43%) and cryptogenic stroke (OR = 3.98, 95% CI = 1.62-9.77, I2 = 0%). Diabetes mellitus was found to be more prevalent among SARS-CoV-2 stroke patients compared to noninfected historical controls (OR = 1.39, 95% CI = 1.00-1.94, I2 = 0%). SARS-CoV-2 infection status was not associated with the likelihood of receiving intravenous thrombolysis (OR = 1.42, 95% CI = 0.65-3.10, I2 = 0%) or endovascular thrombectomy (OR = 0.78, 95% CI = 0.35-1.74, I2 = 0%) among hospitalized ischemic stroke patients during the COVID-19 pandemic. Odds of in-hospital mortality were higher among SARS-CoV-2 stroke patients compared to noninfected contemporary or historical stroke patients (OR = 5.60, 95% CI = 3.19-9.80, I2 = 45%).Interpretation: SARS-CoV-2 appears to be associated with an increased risk of ischemic stroke, and potentially cryptogenic stroke in particular. It may also be related to an increased mortality risk. ANN NEUROL 2021;89:380-388.
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
Clinical Neurology
Disease
Comorbidity
03 medical and health sciences
0302 clinical medicine
Internal medicine
Epidemiology
medicine
Diabetes Mellitus
Humans
Thrombolytic Therapy
[SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]
Hospital Mortality
Stroke
Research Articles
Thrombectomy
business.industry
SARS-CoV-2
Case-control study
COVID-19
Odds ratio
medicine.disease
3. Good health
030104 developmental biology
Neurology
Meta-analysis
Case-Control Studies
[SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]
Neurology (clinical)
business
030217 neurology & neurosurgery
Cohort study
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 03645134 and 15318249
- Database :
- OpenAIRE
- Journal :
- Annals of Neurology, Annals of Neurology, Wiley, 2021, 89 (2), pp.380-388. ⟨10.1002/ana.25967⟩, Annals of Neurology, 2021, 89 (2), pp.380-388. ⟨10.1002/ana.25967⟩
- Accession number :
- edsair.doi.dedup.....4eaf27ba6d6c0aaec9817d941855113a