COVID-19 严重程度与缺血性脑卒中的关系：系统评价和荟萃分析。
The relationship between COVID-19's severity and ischemic stroke: a systematic review and meta-analysis.
机构信息
Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China.
出版信息
Neurol Sci. 2021 Jul;42(7):2645-2651. doi: 10.1007/s10072-021-05299-8. Epub 2021 May 5.
OBJECTIVE
We aim to determine the risk of acute ischemic stroke in patients with severe and non-severe coronavirus disease 2019 (COVID-19).
METHODS
A literature search was conducted in the PubMed, Embase, Web of Science, and Cochrane Library databases until October 28, 2020. Studies covering COVID-19's severity classification data and COVID-19 patients with acute ischemic stroke were included. Two independent evaluators extracted data, and the random effects model was used to calculate the risk ratios (RR) and 95% confidence interval (95% CI) of acute ischemic stroke associated with COVID-19's severity.
RESULTS
A total of 8 studies were included, involving 5266 patients. Among all COVID-19 patients, the total incidence of ischemic stroke was 1.76% (95% CI: 0.82-3.01). Severe patients have an increased risk of acute ischemic stroke compared with non-severe patients (RR = 3.53, 95% CI: 2.06-6.07, P < 0.0001; I = 12%). This association was also observed when COVID-19's severity was defined by clinical parameters (RR 2.91, 95% CI: 1.17-7.26, P = 0.02; I = 29%) and the need for intensive care (RR 4.47, 95% CI: 2.40-8.31, P < 0.0001; I = 0%).
CONCLUSIONS
This meta-analysis shows that the severe course of COVID-19 is associated with an increased risk of acute ischemic stroke.
目的
我们旨在确定重症和非重症 2019 冠状病毒病（COVID-19）患者发生急性缺血性脑卒中的风险。
方法
检索 PubMed、Embase、Web of Science 和 Cochrane Library 数据库，检索时限截至 2020 年 10 月 28 日，纳入包含 COVID-19 严重程度分类数据和 COVID-19 合并急性缺血性脑卒中患者的研究。由 2 位评价员独立提取资料，采用随机效应模型计算 COVID-19 严重程度与急性缺血性脑卒中风险的比值比（RR）及其 95%置信区间（95%CI）。
结果
共纳入 8 项研究，包含 5266 例患者。在所有 COVID-19 患者中，缺血性脑卒中的总发生率为 1.76%（95%CI：0.82%3.01%）。与非重症患者相比，重症患者发生急性缺血性脑卒中的风险更高（RR=3.53，95%CI：2.066.07，P<0.0001；I²=12%）。当 COVID-19 严重程度由临床参数（RR=2.91，95%CI：1.177.26，P=0.02；I²=29%）和需要重症监护来定义时，也观察到这种相关性（RR=4.47，95%CI：2.408.31，P<0.0001；I²=0%）。
结论
该荟萃分析表明，COVID-19 重症患者发生急性缺血性脑卒中的风险增加。
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