Jurkevičienė Justina, Vaišvilas Mantas, Masiliūnas Rytis, Matijošaitis Vaidas, Vaitkus Antanas, Geštautaitė Dovilė, Taroza Saulius, Puzinas Paulius, Galvanauskaitė Erika, Jatužis Dalius, Vilionskis Aleksandras
Stroke Centre, Republican Vilnius University Hospital, 04130 Vilnius, Lithuania.
Center of Neurology, Vilnius University, 08661 Vilnius, Lithuania.
J Clin Med. 2022 May 26;11(11):3004. doi: 10.3390/jcm11113004.
(1) Background: Acute ischemic stroke (AIS) is a possible complication of the coronavirus disease 2019 (COVID-19). Safety and efficacy data on reperfusion therapies (RT)-intravenous thrombolysis and endovascular treatment (EVT)-in stroke patients with COVID-19 is lacking. (2) Methods: We performed a retrospective nationwide multi-center pair-matched analysis of COVID-19 patients with AIS who underwent RT. We included adult COVID-19 patients with AIS who were treated with RT between 16 March 2020 and 30 June 2021. All subjects were paired with non-infected controls, matched for age, sex, stroke arterial vascular territory, and RT modality. The primary outcome measure was a favorable functional outcome defined by the modified Rankin scale (mRS 0-2). (3) Results: Thirty-one subjects and thirty-one matched controls were included. The median baseline National Institutes of Health Stroke Scale (NIHSS) score was higher in the COVID-19 group (16 vs. 12, = 0.028). Rates of ischemic changes and symptomatic intracerebral hemorrhages did not differ significantly between the two groups at 24 h after RT. The median NIHSS 24 h after reperfusion remained significantly higher in the COVID-19 group (16 vs. 5, = 0.003). MRS 0-2 at discharge was significantly less common in COVID-19 patients (22.6% vs. 51.8%, = 0.018). Three-month mortality was 54.8% in the COVID-19 group versus 12.9% in controls ( = 0.001). (4) Conclusion: Reperfusion therapies on AIS in COVID-19 patients appear to be safe; however, functional outcomes are significantly worse, and 3-month mortality is higher.
（1）背景：急性缺血性卒中（AIS）是2019冠状病毒病（COVID-19）的一种可能并发症。目前缺乏关于COVID-19卒中患者再灌注治疗（RT）——静脉溶栓和血管内治疗（EVT）——的安全性和有效性数据。（2）方法：我们对接受RT的COVID-19合并AIS患者进行了一项全国性回顾性多中心配对分析。纳入了2020年3月16日至2021年6月30日期间接受RT治疗的成年COVID-19合并AIS患者。所有受试者均与未感染的对照组配对，根据年龄、性别、卒中动脉血管区域和RT方式进行匹配。主要结局指标是改良Rankin量表（mRS 0 - 2）定义的良好功能结局。（3）结果：纳入了31名受试者和31名匹配的对照组。COVID-19组的基线美国国立卫生研究院卒中量表（NIHSS）评分中位数更高（16对12，P = 0.028）。RT后24小时，两组之间的缺血性改变和症状性脑出血发生率无显著差异。再灌注后24小时，COVID-19组的NIHSS评分中位数仍显著更高（16对5，P = 0.003）。COVID-19患者出院时mRS 0 - 2的情况明显较少见（22.6%对51.8%，P = 0.018）。COVID-19组的3个月死亡率为54.8%，而对照组为12.9%（P = 0.001）。（4）结论：COVID-19患者AIS的再灌注治疗似乎是安全的；然而，功能结局明显更差，3个月死亡率更高。
