Τίτλος:
The Impact of SARS-CoV-2 on Stroke Epidemiology and Care: A Meta-Analysis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objective: Emerging data indicate an increased risk of cerebrovascular events with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and highlight the potential impact of coronavirus disease (COVID-19) on the management and outcomes of acute stroke. We conducted a systematic review and meta-analysis to evaluate the aforementioned considerations. Methods: We performed a meta-analysis of observational cohort studies reporting on the occurrence and/or outcomes of patients with cerebrovascular events in association with their SARS-CoV-2 infection status. We used a random-effects model. Summary estimates were reported as odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Results: We identified 18 cohort studies including 67,845 patients. Among patients with SARS-CoV-2, 1.3% (95% CI = 0.9–1.6%, I2 = 87%) were hospitalized for cerebrovascular events, 1.1% (95% CI = 0.8–1.3%, I2 = 85%) for ischemic stroke, and 0.2% (95% CI = 0.1–0.3%, I2 = 64%) for hemorrhagic stroke. Compared to noninfected contemporary or historical controls, patients with SARS-CoV-2 infection had increased odds of ischemic stroke (OR = 3.58, 95% CI = 1.43–8.92, I2 = 43%) and cryptogenic stroke (OR = 3.98, 95% CI = 1.62–9.77, I2 = 0%). Diabetes mellitus was found to be more prevalent among SARS-CoV-2 stroke patients compared to noninfected historical controls (OR = 1.39, 95% CI = 1.00–1.94, I2 = 0%). SARS-CoV-2 infection status was not associated with the likelihood of receiving intravenous thrombolysis (OR = 1.42, 95% CI = 0.65–3.10, I2 = 0%) or endovascular thrombectomy (OR = 0.78, 95% CI = 0.35–1.74, I2 = 0%) among hospitalized ischemic stroke patients during the COVID-19 pandemic. Odds of in-hospital mortality were higher among SARS-CoV-2 stroke patients compared to noninfected contemporary or historical stroke patients (OR = 5.60, 95% CI = 3.19–9.80, I2 = 45%). Interpretation: SARS-CoV-2 appears to be associated with an increased risk of ischemic stroke, and potentially cryptogenic stroke in particular. It may also be related to an increased mortality risk. ANN NEUROL 2021;89:380–388. © 2020 American Neurological Association
Συγγραφείς:
Katsanos, A.H.
Palaiodimou, L.
Zand, R.
Yaghi, S.
Kamel, H.
Navi, B.B.
Turc, G.
Romoli, M.
Sharma, V.K.
Mavridis, D.
Shahjouei, S.
Catanese, L.
Shoamanesh, A.
Vadikolias, K.
Tsioufis, K.
Lagiou, P.
Alexandrov, A.V.
Tsiodras, S.
Tsivgoulis, G.
Περιοδικό:
Annals of Neurology
Εκδότης:
John Wiley and Sons Inc
Λέξεις-κλειδιά:
fibrinolytic agent, adult; adverse outcome; Article; brain hemorrhage; brain ischemia; cerebral sinus thrombosis; cerebrovascular accident; cerebrovascular disease; clinical evaluation; cohort analysis; comparative study; controlled study; coronavirus disease 2019; demography; diabetes mellitus; disease association; fibrinolytic therapy; historical research; hospital mortality; hospital patient; human; observational study; pandemic; patient care; percutaneous thrombectomy; prevalence; priority journal; prospective study; retrospective study; Severe acute respiratory syndrome coronavirus 2; stroke patient; systematic review; case control study; cerebrovascular accident; comorbidity; hospital mortality; meta analysis; thrombectomy, Case-Control Studies; Comorbidity; COVID-19; Diabetes Mellitus; Hospital Mortality; Humans; SARS-CoV-2; Stroke; Thrombectomy; Thrombolytic Therapy
