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中国武汉有卒中史的 COVID-19 患者的临床特征和结局。

Clinical Characteristics and Outcomes of COVID-19 Patients With a History of Stroke in Wuhan, China.

机构信息

Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (C.Q., L.Z., Z.H., S.Y., M.C., H.Y., D.-S.T., W.W.).

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (S.Z.).

出版信息

Stroke. 2020 Jul;51(7):2219-2223. doi: 10.1161/STROKEAHA.120.030365. Epub 2020 May 29.

Abstract

BACKGROUND AND PURPOSE

Information on stroke survivors infected with coronavirus disease 2019 (COVID-19) is limited. The aim of this study was to describe specific clinical characteristics and outcomes of patients with COVID-19 with a history of stroke.

METHODS

All the confirmed cases of COVID-19 at Tongji Hospital from January 27 to March 5, 2020, were included in our cohort study. Clinical data were analyzed and compared between patients with and without a history of stroke.

RESULTS

Of the included 1875 patients with COVID-19, 50 patients had a history of stroke. The COVID-19 patients with medical history of stroke were older with more comorbidities, had higher neutrophil count, and lower lymphocyte and platelet counts than those without history of stroke. The levels of D-dimers, cardiac troponin I, NT pro-brain natriuretic peptide, and interleukin-6 were also markedly higher in patients with history of stroke. Stroke survivors who underwent COVID-19 developed more acute respiratory distress syndrome and received more noninvasive mechanical ventilation. Data from propensity-matched analysis indicated a higher proportion of patients with COVD-19 with a history of stroke were admitted to the intensive care unit requiring mechanical ventilation and were more likely to be held in the unit or die, compared with non-stroke history COVID-19 patients.

CONCLUSIONS

Patients with COVID-19 with a history of stroke had more severe clinical symptoms and poorer outcomes compared with those without a history of stroke.

摘要

背景与目的

关于感染 2019 年冠状病毒病(COVID-19)的脑卒中幸存者的信息有限。本研究旨在描述 COVID-19 病史患者的特定临床特征和结局。

方法

本队列研究纳入了 2020 年 1 月 27 日至 3 月 5 日期间在同济医院确诊的所有 COVID-19 病例。分析并比较了有和无脑卒中史患者的临床数据。

结果

在纳入的 1875 例 COVID-19 患者中,有 50 例有脑卒中史。与无脑卒中史的 COVID-19 患者相比,COVID-19 合并脑卒中史的患者年龄较大,合并症更多,中性粒细胞计数更高,淋巴细胞和血小板计数更低。脑卒中史患者的 D-二聚体、心肌肌钙蛋白 I、NT 脑利钠肽前体和白细胞介素-6 水平也明显升高。COVID-19 合并脑卒中史的患者更易发生急性呼吸窘迫综合征,需要更多的无创机械通气。倾向评分匹配分析的数据表明,与无脑卒中史 COVID-19 患者相比,COVID-19 合并脑卒中史的患者更有可能入住需要机械通气的重症监护病房,更有可能在重症监护病房中留观或死亡。

结论

与无脑卒中史的 COVID-19 患者相比,COVID-19 合并脑卒中史的患者临床症状更严重,结局更差。

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