COVID-19 Affects Short-Term, But Not 90-Day, Outcome in Patients With Stroke Treated With Mechanical Thrombectomy

被引:0
作者
Beckonert, Niklas M. [1 ,2 ]
Bode, Felix J. [1 ]
Dorn, Franziska [3 ]
Stoesser, Sebastian [1 ]
Meissner, Julius N. [1 ]
Nordsiek, Julia [1 ]
Kindler, Christine [1 ]
Ebrahimi, Taraneh [1 ]
Riegler, Christoph [4 ,5 ,6 ,7 ,8 ]
Nolte, Christian H. [4 ,5 ,6 ,7 ,8 ]
Petzold, Gabor C. [1 ,2 ]
Weller, Johannes M. [1 ]
机构
[1] Univ Hosp Bonn, Dept Neurol, Div Vasc Neurol, Bonn, Germany
[2] German Ctr Neurodegenerat Dis, Vasc Neurol Res Grp, Bonn, Nordrhein Westf, Germany
[3] Univ Hosp Bonn, Dept Neuroradiol, Bonn, Germany
[4] Charite Univ Med Berlin, Klin & Hsch ambulanz Neurol, Berlin, Germany
[5] Free Univ Berlin, Berlin, Germany
[6] Humboldt Univ, Berlin, Germany
[7] Berlin Inst Hlth, Berlin, Germany
[8] Charite Univ Med Berlin, Ctr Stroke Res Berlin, Berlin, Germany
来源
STROKE-VASCULAR AND INTERVENTIONAL NEUROLOGY | 2023年 / 3卷 / 05期
关键词
clinical outcome; COVID-19; endovascular treatment; mechanical thrombectomy; stroke; ISCHEMIC-STROKE; ENDOVASCULAR THROMBECTOMY;
D O I
10.1161/SVIN.123.000915
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND: COVID-19 is associated with an increased stroke risk. Moreover, outcome at discharge was worse in patients with large-vessel occlusion stroke with concomitant COVID-19 receiving endovascular treatment (ET). We aimed to investigate the impact of concomitant COVID-19 on later functional outcome in patients with large-vessel occlusion stroke treated with ET. METHODS: We analyzed patients fromthe GSR-ET (German Stroke Registry-Endovascular Treatment), an observational multicenter registry of patients with large-vessel occlusion stroke receiving ET. Baseline characteristics, procedural parameters, discharge parameters, and functional outcome at 90 days were compared between patients with concomitant COVID-19 and propensity score-matched controls (ratio, 1:4; matched for age, sex, prestroke modified Rankin Scale score, and stroke severity), and multivariable ordinal regression analysis was performed. RESULTS: Among 4010 patients receiving ET between February 2020 and December 2021, 72 (1.8%) had concomitant COVID-19. Compared with 224 matched patients without COVID-19, they (n=56) were more severely affected, with a higher median National Institutes of Health Stroke Scale (NIHSS) score after 24 hours (NIHSS score, 14.5 [interquartile range {IQR}, 9-22] versus 12 [IQR, 6-18.75]; P=0.015), and NIHSS score and modified Rankin Scale score at discharge (NIHSS score, 12 [IQR, 6.75-16.75] versus 6 [IQR, 2-13]; P=0.001; and modified Rankin Scale score, 5 [IQR, 4-5] versus 4 [IQR, 2-5]; P=0.023), but functional outcome at 90-day follow-up was similar (modified Rankin Scale score, 4 [IQR, 4-6] versus 4 [IQR, 2-6]; P=0.34). After adjustment for prespecified confounders, COVID-19 was associated with worse functional outcome at discharge (common odds ratio [OR], 0.40 [95% CI, 0.19-0.80]; P=0.011), but not at 90-day follow-up (common OR, 0.72 [95% CI, 0.32-1.60]; P=0.43). CONCLUSIONS: COVID-19 affected short-term, but not 90-day, functional outcome in patients with large-vessel occlusion stroke treated with ET. Hence, ET should not be withheld in patients with concomitant COVID-19.
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