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Outcomes Worse for COVID-19-Linked Ischemic Strokes

TUESDAY, July 14, 2020 -- COVID-19-associated ischemic strokes are more severe than non-COVID-19 ischemic strokes, with worse functional outcome and increased mortality, according to a study published online July 9 in Stroke.

George Ntaios, M.D., Ph.D., from the University of Thessaly in Larissa, Greece, and colleagues pooled data from all consecutive patients hospitalized with laboratory-confirmed COVID-19 and acute ischemic stroke at 28 sites from 16 countries and examined whether stroke severity and outcomes differed for patients with versus without COVID-19. A total of 174 COVID-19 patients with acute ischemic stroke between Jan. 27, 2020, and May 19, 2020, were propensity score-matched in a 1:1 ratio with non-COVID-19 patients.

The researchers found that the median National Institute of Health Stroke Scale was higher in patients with COVID-19 versus matched patients without COVID-19 (10 versus 6; odds ratio, 1.69 for higher National Institute of Health Stroke Scale score). There were 48 deaths, including 22 and 26 attributable to stroke and COVID-19, respectively. Forty-nine of 96 survivors with information about disability status had severe disability at discharge. In the propensity score-matched population, patients with COVID-19 had a significantly increased risk for severe disability (median modified Rankin Scale, 4 versus 2) and death (adjusted odds ratio, 4.3).

"The association between COVID-19 and severe stroke highlights the urgent need for studies aiming to uncover the underlying mechanisms and is relevant for prehospital stroke awareness and in-hospital acute stroke pathways during the current and future pandemics," the authors write.

Several authors disclosed financial ties to the pharmaceutical and medical device industries.

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Posted: July 2020

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