Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study
(1) Background: Acute ischemic stroke (AIS) is a possible complication of the coronavirus disease 2019 (COVID-19). Safety and efficacy data on reperfusion therapies (RT)—intravenous thrombolysis and endovascular treatment (EVT)—in stroke patients with COVID-19 is lacking. (2) Methods: We performed a...
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| Format: | Article |
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MDPI AG
2022-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/11/3004 |
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| author | Justina Jurkevičienė Mantas Vaišvilas Rytis Masiliūnas Vaidas Matijošaitis Antanas Vaitkus Dovilė Geštautaitė Saulius Taroza Paulius Puzinas Erika Galvanauskaitė Dalius Jatužis Aleksandras Vilionskis |
| author_facet | Justina Jurkevičienė Mantas Vaišvilas Rytis Masiliūnas Vaidas Matijošaitis Antanas Vaitkus Dovilė Geštautaitė Saulius Taroza Paulius Puzinas Erika Galvanauskaitė Dalius Jatužis Aleksandras Vilionskis |
| author_sort | Justina Jurkevičienė |
| collection | DOAJ |
| description | (1) Background: Acute ischemic stroke (AIS) is a possible complication of the coronavirus disease 2019 (COVID-19). Safety and efficacy data on reperfusion therapies (RT)—intravenous thrombolysis and endovascular treatment (EVT)—in stroke patients with COVID-19 is lacking. (2) Methods: We performed a retrospective nationwide multi-center pair-matched analysis of COVID-19 patients with AIS who underwent RT. We included adult COVID-19 patients with AIS who were treated with RT between 16 March 2020 and 30 June 2021. All subjects were paired with non-infected controls, matched for age, sex, stroke arterial vascular territory, and RT modality. The primary outcome measure was a favorable functional outcome defined by the modified Rankin scale (mRS 0–2). (3) Results: Thirty-one subjects and thirty-one matched controls were included. The median baseline National Institutes of Health Stroke Scale (NIHSS) score was higher in the COVID-19 group (16 vs. 12, <i>p</i> = 0.028). Rates of ischemic changes and symptomatic intracerebral hemorrhages did not differ significantly between the two groups at 24 h after RT. The median NIHSS 24 h after reperfusion remained significantly higher in the COVID-19 group (16 vs. 5, <i>p</i> = 0.003). MRS 0–2 at discharge was significantly less common in COVID-19 patients (22.6% vs. 51.8%, <i>p</i> = 0.018). Three-month mortality was 54.8% in the COVID-19 group versus 12.9% in controls (<i>p</i> = 0.001). (4) Conclusion: Reperfusion therapies on AIS in COVID-19 patients appear to be safe; however, functional outcomes are significantly worse, and 3-month mortality is higher. |
| first_indexed | 2024-03-10T01:11:55Z |
| format | Article |
| id | doaj.art-17e5f6171e4b4ef6bf0758adfbc425f7 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T01:11:55Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-17e5f6171e4b4ef6bf0758adfbc425f72023-11-23T14:15:09ZengMDPI AGJournal of Clinical Medicine2077-03832022-05-011111300410.3390/jcm11113004Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center StudyJustina Jurkevičienė0Mantas Vaišvilas1Rytis Masiliūnas2Vaidas Matijošaitis3Antanas Vaitkus4Dovilė Geštautaitė5Saulius Taroza6Paulius Puzinas7Erika Galvanauskaitė8Dalius Jatužis9Aleksandras Vilionskis10Stroke Centre, Republican Vilnius University Hospital, 04130 Vilnius, LithuaniaStroke Centre, Republican Vilnius University Hospital, 04130 Vilnius, LithuaniaCenter of Neurology, Vilnius University, 08661 Vilnius, LithuaniaDepartment of Neurology, Lithuanian University of Health Sciences, 50009 Kaunas, LithuaniaDepartment of Neurology, Lithuanian University of Health Sciences, 50009 Kaunas, LithuaniaDepartment of Neurology, Lithuanian University of Health Sciences, 50009 Kaunas, LithuaniaLaboratory of Behavioral Medicine (Palanga), Neuroscience Institute, Lithuanian University of Health Sciences, 00135 Palanga, LithuaniaDepartment of Neurology, Republican Panevėžys Hospital, 35144 Panevėžys, LithuaniaDepartment of Neurology, Republican Šiauliai Hospital, 76231 Šiauliai, LithuaniaCenter of Neurology, Vilnius University, 08661 Vilnius, LithuaniaClinic of Neurology and Neurosurgery, Vilnius University, 03101 Vilnius, Lithuania(1) Background: Acute ischemic stroke (AIS) is a possible complication of the coronavirus disease 2019 (COVID-19). Safety and efficacy data on reperfusion therapies (RT)—intravenous thrombolysis and endovascular treatment (EVT)—in stroke patients with COVID-19 is lacking. (2) Methods: We performed a retrospective nationwide multi-center pair-matched analysis of COVID-19 patients with AIS who underwent RT. We included adult COVID-19 patients with AIS who were treated with RT between 16 March 2020 and 30 June 2021. All subjects were paired with non-infected controls, matched for age, sex, stroke arterial vascular territory, and RT modality. The primary outcome measure was a favorable functional outcome defined by the modified Rankin scale (mRS 0–2). (3) Results: Thirty-one subjects and thirty-one matched controls were included. The median baseline National Institutes of Health Stroke Scale (NIHSS) score was higher in the COVID-19 group (16 vs. 12, <i>p</i> = 0.028). Rates of ischemic changes and symptomatic intracerebral hemorrhages did not differ significantly between the two groups at 24 h after RT. The median NIHSS 24 h after reperfusion remained significantly higher in the COVID-19 group (16 vs. 5, <i>p</i> = 0.003). MRS 0–2 at discharge was significantly less common in COVID-19 patients (22.6% vs. 51.8%, <i>p</i> = 0.018). Three-month mortality was 54.8% in the COVID-19 group versus 12.9% in controls (<i>p</i> = 0.001). (4) Conclusion: Reperfusion therapies on AIS in COVID-19 patients appear to be safe; however, functional outcomes are significantly worse, and 3-month mortality is higher.https://www.mdpi.com/2077-0383/11/11/3004COVID-19ischemic strokethrombolysisthrombectomyLithuaniareperfusion therapies |
| spellingShingle | Justina Jurkevičienė Mantas Vaišvilas Rytis Masiliūnas Vaidas Matijošaitis Antanas Vaitkus Dovilė Geštautaitė Saulius Taroza Paulius Puzinas Erika Galvanauskaitė Dalius Jatužis Aleksandras Vilionskis Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study Journal of Clinical Medicine COVID-19 ischemic stroke thrombolysis thrombectomy Lithuania reperfusion therapies |
| title | Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study |
| title_full | Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study |
| title_fullStr | Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study |
| title_full_unstemmed | Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study |
| title_short | Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study |
| title_sort | reperfusion therapies for acute ischemic stroke in covid 19 patients a nationwide multi center study |
| topic | COVID-19 ischemic stroke thrombolysis thrombectomy Lithuania reperfusion therapies |
| url | https://www.mdpi.com/2077-0383/11/11/3004 |
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