Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Medicine (Baltimore). 2022 Jul 1;101(26):e29834. doi: 10.1097/MD.0000000000029834.
We assessed whether stroke severity, functional outcome, and mortality in patients with ischemic stroke differed between patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and those without. We conducted a prospective, single-center cohort study in Irbid, North Jordan. All patients diagnosed with ischemic stroke and SARS-CoV-2 infection were consecutively recruited from October 15, 2020, to October 16, 2021. We recorded demographic data, vascular risk factors, National Institutes of Health Stroke Scale (NIHSS) score, stroke subtype according to the Trial of ORG 10172 in Acute Stroke Treatment Criteria (TOAST), treatments at admission, and laboratory variables for all patients. The primary endpoint was the functional outcome at 3 months assessed using the modified Rankin Score. Secondary outcomes involved in-hospital mortality and mortality at 3 months. We included 178 patients with a mean (standard deviation) age of 67.3 (12), and more than half of the cases were males (96/178; 53.9%). Thirty-six cases were coronavirus disease 2019 (COVID-19) related and had a mean (standard deviation) age of 70 (11.5). When compared with COVID-19-negative patients, COVID-19-positive patients were more likely to have a higher median NIHSS score at baseline (6 vs 11; P = .043), after 72 hours (6 vs 12; P = .006), and at discharge (4 vs 16; P < .001). They were also more likely to have a higher median modified Rankin Score after 3 months of follow-up (P < .001). NIHSS score at admission (odds ratio = 1.387, 95% confidence interval = 1.238-1.553]; P < .001) predicted having an unfavorable outcome after 3 months. On the other hand, having a concomitant SARS-CoV-2 infection did not significantly impact the likelihood of unfavorable outcomes (odds ratio = 1.098, 95% confidence interval = 0.270-4.473; P = .896). The finding conclude that SARS-CoV-2 infection led to an increase in both stroke severity and in-hospital mortality but had no significant impact on the likelihood of developing unfavorable outcomes.
我们评估了患有严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染的缺血性脑卒中患者与未感染 SARS-CoV-2 的患者之间的脑卒中严重程度、功能结局和死亡率是否存在差异。我们在约旦北部的伊尔比德进行了一项前瞻性、单中心队列研究。从 2020 年 10 月 15 日至 2021 年 10 月 16 日，连续招募了所有被诊断为缺血性脑卒中合并 SARS-CoV-2 感染的患者。我们记录了所有患者的人口统计学数据、血管危险因素、国立卫生研究院脑卒中量表（NIHSS）评分、根据急性脑卒中治疗试验的 ORG 10172 标准（TOAST）分类的脑卒中亚型、入院时的治疗以及实验室变量。主要终点是使用改良 Rankin 评分评估的 3 个月时的功能结局。次要结局包括住院死亡率和 3 个月时的死亡率。我们纳入了 178 例患者，平均年龄（标准差）为 67.3（12）岁，其中一半以上为男性（96/178；53.9%）。36 例与 2019 年冠状病毒病（COVID-19）相关，平均年龄为 70（11.5）岁。与 COVID-19 阴性患者相比，COVID-19 阳性患者的基线（6 分比 11 分；P=0.043）、72 小时后（6 分比 12 分；P=0.006）和出院时（4 分比 16 分；P＜0.001）的 NIHSS 评分中位数更高。他们在随访 3 个月后也更有可能具有更高的中位改良 Rankin 评分（P＜0.001）。入院时的 NIHSS 评分（比值比=1.387，95%置信区间=1.238-1.553]；P＜0.001）预测 3 个月后结局不良。另一方面，合并 SARS-CoV-2 感染并不显著影响不良结局的可能性（比值比=1.098，95%置信区间=0.270-4.473；P=0.896）。该研究结果表明，SARS-CoV-2 感染导致脑卒中严重程度和住院死亡率均升高，但对不良结局的可能性无显著影响。
