Volume 2, Issue 1 And Supplement (Winter 2021)
J Vessel Circ 2021, 2(1 And Supplement): 59-59 |
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Almasi-Dooghaee M, Mirzaasgari Z, Moghadas F, Khoeini T, Ramezani Ghamsari M, Lotfi T, et al . COVID-19 Increases the Mortality Rate of Stroke: Is It True and What Are the Predictors?. J Vessel Circ 2021; 2 (1) :59-59
URL: http://jvessels.muq.ac.ir/article-1-147-en.html
URL: http://jvessels.muq.ac.ir/article-1-147-en.html
Mostafa Almasi-Dooghaee * 
1, Zahra Mirzaasgari1 , Fatemeh Moghadas2 , Tara Khoeini3 , Mona Ramezani Ghamsari4 , Tayebeh Lotfi2 , Seyedehnarges Tabatabaee3 , Matineh Heidari3 , Zakieh Shafiee3 , Roya Yazdani3 , Mehdi Moghaddasi5
1, Zahra Mirzaasgari1 , Fatemeh Moghadas2 , Tara Khoeini3 , Mona Ramezani Ghamsari4 , Tayebeh Lotfi2 , Seyedehnarges Tabatabaee3 , Matineh Heidari3 , Zakieh Shafiee3 , Roya Yazdani3 , Mehdi Moghaddasi5
1- MD, Assistant professor, Firoozgar hospital, Neurology Department, Iran University of Medical Sciences, Tehran, Iran
2- MD, Neurology resident, Hazrat-Rasoul hospital, Neurology Department, Iran University of Medical Sciences, Tehran, Iran
3- MD, Neurology resident r, Firoozgar hospital, Neurology Department, Iran University of Medical Sciences, Tehran, Iran
4- MD, Assistant professor, Clinical Research Development Unit of Shahid Rejaei, Educational & Medical Centre, Alborz University of Medical Sciences, Karaj, Iran
5- MD, Professor, Hazrat-Rasoul hospital, Neurology Department, Iran University of Medical Sciences, Tehran, Iran
2- MD, Neurology resident, Hazrat-Rasoul hospital, Neurology Department, Iran University of Medical Sciences, Tehran, Iran
3- MD, Neurology resident r, Firoozgar hospital, Neurology Department, Iran University of Medical Sciences, Tehran, Iran
4- MD, Assistant professor, Clinical Research Development Unit of Shahid Rejaei, Educational & Medical Centre, Alborz University of Medical Sciences, Karaj, Iran
5- MD, Professor, Hazrat-Rasoul hospital, Neurology Department, Iran University of Medical Sciences, Tehran, Iran
Abstract: (788 Views)
Background and Aim: COVID-19 pandemic has become a major challenging issue worldwide after its emergence in December 2019 from Wuhan China. Although the most common and significant complication is respiratory symptoms, reports of neurological features are increasing. Not only ischemic stroke could be a life-threatening complication of COVID-19 infected patients, there are reports of ischemic stroke as a presenting feature of COVID-19 as well. The aim of this study was to determine the mortality rate and its predictor in patients with stroke and COVID-19.
Materials and Methods: We performed a retrospective study of stroke patients, who admitted to three referral hospitals in Tehran and Karaj, Iran, during the first 3 months of the pandemic period, investigate the outcome including need to mechanical ventilation and death, and compare them to similar period in a year before COVID-19. The predictors for final outcome of death was determined. Data were analyzed with SPSS 18 version using T-test and Chi-square. The P value below 0.05 was considered statistically significant.
Results: 124 individuals with stroke were admitted in three centers within first three months of COVID-19 pandemic. The diagnosis of COVID-19 was documented in 59 individuals (47.6%), including 8 subjects with PCR and 46 subjects with typical appearance of lung involvement in chest CT scan. The initial NIHSS was 14.2±7.4 and 10.7±7.9 in COVID positive and COVID negative patients (P=0.053). Mechanical ventilation was done in 59.3% and 27.4% of COVID positive and COVID negative patients (P=0.001). Final outcome of death, including during admission or after discharge, was observed in 47.5% and 21.0% of COVID positive and COVID negative patients (P=0.025). The predictors for death in COVID positive patients included hemorrhagic stroke (P=0.013), the stroke in territory of MCA or ICA (P=0.042), main vessel occlusion as the mechanism of stroke (P<0.001) and presence of atrial fibrillation (P<0.001). There was no difference between the frequency of these factors between COVID-19 positive and COVID-19 negative patients (P>0.05).
One year before COVID-19 and within the similar duration, the death was observed in 36/186 (19.4%) of stroke patients. The involvement of lungs were observed in 16/24 (66.7%) patients with outcome of death (P<0.001). Except for hemorrhagic stroke (P=0.002), the other predictors of death from stroke in COVID-19 patients had no relationship with outcome of death.
Conclusion: The mortality rate of stroke in COVID-positive patients is more than 2 times compared to COVID-negative patients. The hemorrhagic stroke, large vessel occlusion and atrial fibrillation are the predictor of death in COVID-19 patients. The mortality rate of stroke in patients without COVID-19 is similar to the mortality rate of stroke one year before the emergence of COVID-19.
Materials and Methods: We performed a retrospective study of stroke patients, who admitted to three referral hospitals in Tehran and Karaj, Iran, during the first 3 months of the pandemic period, investigate the outcome including need to mechanical ventilation and death, and compare them to similar period in a year before COVID-19. The predictors for final outcome of death was determined. Data were analyzed with SPSS 18 version using T-test and Chi-square. The P value below 0.05 was considered statistically significant.
Results: 124 individuals with stroke were admitted in three centers within first three months of COVID-19 pandemic. The diagnosis of COVID-19 was documented in 59 individuals (47.6%), including 8 subjects with PCR and 46 subjects with typical appearance of lung involvement in chest CT scan. The initial NIHSS was 14.2±7.4 and 10.7±7.9 in COVID positive and COVID negative patients (P=0.053). Mechanical ventilation was done in 59.3% and 27.4% of COVID positive and COVID negative patients (P=0.001). Final outcome of death, including during admission or after discharge, was observed in 47.5% and 21.0% of COVID positive and COVID negative patients (P=0.025). The predictors for death in COVID positive patients included hemorrhagic stroke (P=0.013), the stroke in territory of MCA or ICA (P=0.042), main vessel occlusion as the mechanism of stroke (P<0.001) and presence of atrial fibrillation (P<0.001). There was no difference between the frequency of these factors between COVID-19 positive and COVID-19 negative patients (P>0.05).
One year before COVID-19 and within the similar duration, the death was observed in 36/186 (19.4%) of stroke patients. The involvement of lungs were observed in 16/24 (66.7%) patients with outcome of death (P<0.001). Except for hemorrhagic stroke (P=0.002), the other predictors of death from stroke in COVID-19 patients had no relationship with outcome of death.
Conclusion: The mortality rate of stroke in COVID-positive patients is more than 2 times compared to COVID-negative patients. The hemorrhagic stroke, large vessel occlusion and atrial fibrillation are the predictor of death in COVID-19 patients. The mortality rate of stroke in patients without COVID-19 is similar to the mortality rate of stroke one year before the emergence of COVID-19.
Type of Study: Research |
Subject:
stroke
Received: 2021/09/8 | Accepted: 2021/02/28 | Published: 2021/02/28
Received: 2021/09/8 | Accepted: 2021/02/28 | Published: 2021/02/28
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