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COVID-19 对急性缺血性和出血性脑卒中患者的影响。

The Effects of COVID-19 on Patients with Acute Ischemic and Hemorrhagic Stroke.

机构信息

Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Mazandaran, Iran.

Department of Neurology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

出版信息

J Stroke Cerebrovasc Dis. 2022 Jul;31(7):106512. doi: 10.1016/j.jstrokecerebrovasdis.2022.106512. Epub 2022 Apr 19.

Abstract

OBJECTIVE

The objective of this study was to evaluate how COVID-19 affects patients with acute ischemic or hemorrhagic stroke outcome.

MATERIALS AND METHODS

This retrospective study was performed on adult patients (> 18 years old) with stroke (ischemic or hemorrhagic) who were admitted to hospital with or without COVID-19. The primary outcome was stroke-related disability, which was measured by mRS at baseline and discharge. Hospital duration, intensive care unit (ICU) admission, and mortality were considered the secondary outcomes.

RESULTS

From February 2019 until August 2020, we recruited and analyzed 151 patients, 42 of whom had COVID-19 based on RT-PCR tests or lung CT scan findings. COVID-19 positive patients had higher baseline and final mRS scores than the control group (4.46 ± 0.67 vs 4.79 ± 0.61, P: 0.001, 3.83 ± 1.22 vs 4.46 ± 0.67, P: 0.001). Moreover, stroke patients with COVID-19 experienced a more severe disease and required a higher rate of ICU admission (17 vs 0, P:0.001) and longer hospitalization compared to those without COVID-19 (8.50 ± 7.86 vs 7.5 ± 11.20, P: 0.021). Also, mortality was higher in the COVID-19 group (19 vs 13, P:0.001). There was not any significant differences between the two groups in terms of the involvement of cerebral arteries and type of stroke. Male sex, COVID-19, and ICU admission were the main independent risk factors for death.

CONCLUSION

The results of the study showed stroke patients (ischemic or hemorrhagic) with COVID-19 can have more disabilities and incur more hospital complications and mortality than non-COVID-19 patients.

摘要

目的

本研究旨在评估 COVID-19 如何影响急性缺血性或出血性脑卒中患者的预后。

材料和方法

本回顾性研究纳入了因脑卒中(缺血性或出血性)入院的成年患者(>18 岁),这些患者有或无 COVID-19。主要结局是基线和出院时的 mRS 评分评估的脑卒中相关残疾。住院时间、重症监护病房(ICU)入住和死亡率被认为是次要结局。

结果

2019 年 2 月至 2020 年 8 月,我们共招募并分析了 151 例患者,其中 42 例患者的 COVID-19 通过 RT-PCR 检测或肺部 CT 扫描确诊。与对照组相比,COVID-19 阳性患者的基线和最终 mRS 评分更高(4.46±0.67 vs 4.79±0.61,P:0.001;3.83±1.22 vs 4.46±0.67,P:0.001)。此外,COVID-19 脑卒中患者的疾病更严重,需要更高比例的 ICU 入住(17% vs 0%,P:0.001),住院时间也更长(8.50±7.86 vs 7.5±11.20,P:0.021)。此外,COVID-19 组的死亡率更高(19% vs 13%,P:0.001)。两组之间脑动脉受累和脑卒中类型无显著差异。男性、COVID-19 和 ICU 入住是死亡的主要独立危险因素。

结论

研究结果表明,COVID-19 合并脑卒中(缺血性或出血性)患者的残疾程度更高,发生医院并发症和死亡的风险更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b25/9015955/5b96d6b8f4c5/gr1_lrg.jpg

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