@article{2987574,
    title = "Characteristics and Outcomes in Patients with COVID-19 and Acute Ischemic Stroke: The Global COVID-19 Stroke Registry",
    author = "Ntaios, G. and Michel, P. and Georgiopoulos, G. and Guo, Y. and Li, W. and Xiong, J. and Calleja, P. and Ostos, F. and González-Ortega, G. and Fuentes, B. and Alonso De Leciñana, M. and Díez-Tejedor, E. and García-Madrona, S. and Masjuan, J. and Defelipe, A. and Turc, G. and Gonçalves, B. and Domigo, V. and Dan, G.-A. and Vezeteu, R. and Christensen, H. and Christensen, L.M. and Meden, P. and Hajdarevic, L. and Rodriguez-Lopez, A. and Díaz-Otero, F. and García-Pastor, A. and Gil-Nuñez, A. and Maslias, E. and Strambo, D. and Werring, D.J. and Chandratheva, A. and Benjamin, L. and Simister, R. and Perry, R. and Beyrouti, R. and Jabbour, P. and Sweid, A. and Tjoumakaris, S. and Cuadrado-Godia, E. and Campello, A.R. and Roquer, J. and Moreira, T. and Mazya, M.V. and Bandini, F. and Matz, K. and Iversen, H.K. and González-Duarte, A. and Tiu, C. and Ferrari, J. and Vosko, M.R. and Salzer, H.J.F. and Lamprecht, B. and Dünser, M.W. and Cereda, C.W. and Quintero, Á.B.C. and Korompoki, E. and Soriano-Navarro, E. and Soto-Ramírez, L.E. and Castañeda-Méndez, P.F. and Bay-Sansores, D. and Arauz, A. and Cano-Nigenda, V. and Kristoffersen, E.S. and Tiainen, M. and Strbian, D. and Putaala, J. and Lip, G.Y.H.",
    journal = "ISRN Stroke",
    year = "2020",
    pages = "254-258",
    publisher = "Lippincott Williams and Wilkins",
    issn = "2090-9454",
    doi = "10.1161/STROKEAHA.120.031208",
    keywords = "aged;  brain ischemia;  cerebrovascular accident;  cohort analysis;  complication;  convalescence;  Coronavirus infection;  diagnostic imaging;  disability;  female;  human;  male;  middle aged;  pandemic;  propensity score;  register;  survival analysis;  time to treatment;  treatment outcome;  very elderly;  virus pneumonia;  x-ray computed tomography, Aged;  Aged, 80 and over;  Brain Ischemia;  Cohort Studies;  Coronavirus Infections;  Disability Evaluation;  Female;  Humans;  Male;  Middle Aged;  Pandemics;  Pneumonia, Viral;  Propensity Score;  Recovery of Function;  Registries;  Stroke;  Survival Analysis;  Time-to-Treatment;  Tomography, X-Ray Computed;  Treatment Outcome",
    abstract = "Recent case-series of small size implied a pathophysiological association between coronavirus disease 2019 (COVID-19) and severe large-vessel acute ischemic stroke. Given that severe strokes are typically associated with poor prognosis and can be very efficiently treated with recanalization techniques, confirmation of this putative association is urgently warranted in a large representative patient cohort to alert stroke clinicians, and inform pre- and in-hospital acute stroke patient pathways. We pooled all consecutive patients hospitalized with laboratory-confirmed COVID-19 and acute ischemic stroke in 28 sites from 16 countries. To assess whether stroke severity and outcomes (assessed at discharge or at the latest assessment for those patients still hospitalized) in patients with acute ischemic stroke are different between patients with COVID-19 and non-COVID-19, we performed 1:1 propensity score matching analyses of our COVID-19 patients with non-COVID-19 patients registered in the Acute Stroke Registry and Analysis of Lausanne Registry between 2003 and 2019. Between January 27, 2020, and May 19, 2020, 174 patients (median age 71.2 years; 37.9% females) with COVID-19 and acute ischemic stroke were hospitalized (median of 12 patients per site). The median National Institutes of Health Stroke Scale was 10 (interquartile range [IQR], 4-18). In the 1:1 matched sample of 336 patients with COVID-19 and non-COVID-19, the median National Institutes of Health Stroke Scale was higher in patients with COVID-19 (10 [IQR, 4-18] versus 6 [IQR, 3-14]), P=0.03; (odds ratio, 1.69 [95% CI, 1.08-2.65] for higher National Institutes of Health Stroke Scale score). There were 48 (27.6%) deaths, of which 22 were attributed to COVID-19 and 26 to stroke. Among 96 survivors with available information about disability status, 49 (51%) had severe disability at discharge. In the propensity score-matched population (n=330), patients with COVID-19 had higher risk for severe disability (median mRS 4 [IQR, 2-6] versus 2 [IQR, 1-4], P<0.001) and death (odds ratio, 4.3 [95% CI, 2.22-8.30]) compared with patients without COVID-19. Our findings suggest that COVID-19 associated ischemic strokes are more severe with worse functional outcome and higher mortality than non-COVID-19 ischemic strokes. © 2020 Lippincott Williams and Wilkins. All rights reserved."
}