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COVID-19 对卒中患者取栓结局的影响:一项系统评价和荟萃分析。

The impact of COVID 19 on the outcomes of thrombectomy in stroke patients: A systematic review and meta-analysis.

机构信息

Faculty of Medicine, Minia University, Minia, Egypt.

Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

出版信息

Rev Med Virol. 2023 Jan;33(1):e2379. doi: 10.1002/rmv.2379. Epub 2022 Jul 14.

Abstract

We aimed to conduct the current meta-analysis to provide better insight into the efficacy of mechanical thrombectomy (MT) in managing COVID-19 patients suffering from a stroke. An electronic search was conducted through eight databases for collecting the current evidence about the efficacy of MT in stroke patients with COVID-19 until 18 December 2021. The results were reported as the pooled prevalence rates and the odds ratios (ORs), with their corresponding 95% confidence intervals (CI). Out of 648 records, we included nine studies. The prevalence of stroke patients with COVID-19 who received MT treatment was with TICI ≥2b 79% (95%CI: 73-85), symptomatic intracranial haemorrhage 6% (95%CI: 3-11), parenchymal haematoma type 1, 11.1% (95%CI: 5-23), and mortality 29% (95%CI: 24-35). On further comparison of MT procedure between stroke patients with COVID 19 to those without COVID-19, we found no significant difference in terms of TICI ≥2b score (OR: 0.85; 95%CI: 0.03-23; p = 0.9). However, we found that stroke patients with COVID-19 had a significantly higher mortality rate than stroke patients without COVID-19 after MT procedure (OR: 2.99; 95%CI: 2.01-4.45; p < 0.001). Stroke patients with COVID-19 can be safely and effectively treated with MT, with comparable reperfusion and complication rates to those without the disease.

摘要

我们旨在进行本次荟萃分析,以更好地了解机械血栓切除术(MT)在治疗 COVID-19 卒中患者中的疗效。通过八项数据库进行电子检索,以收集截至 2021 年 12 月 18 日 COVID-19 卒中患者 MT 疗效的现有证据。结果以汇总患病率和比值比(OR)报告,并附有相应的 95%置信区间(CI)。在 648 条记录中,我们纳入了 9 项研究。接受 MT 治疗的 COVID-19 卒中患者的 TICI≥2b 患病率为 79%(95%CI:73-85),症状性颅内出血为 6%(95%CI:3-11),实质血肿类型 1 为 11.1%(95%CI:5-23),死亡率为 29%(95%CI:24-35)。在进一步比较 COVID-19 卒中患者与非 COVID-19 卒中患者的 MT 操作后,我们发现 TICI≥2b 评分方面没有显著差异(OR:0.85;95%CI:0.03-23;p=0.9)。然而,我们发现 COVID-19 卒中患者在 MT 术后的死亡率明显高于非 COVID-19 卒中患者(OR:2.99;95%CI:2.01-4.45;p<0.001)。COVID-19 卒中患者可以安全有效地接受 MT 治疗,其再灌注和并发症发生率与非 COVID-19 卒中患者相当。

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