Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
VASCage, Innsbruck, Austria.
Int J Stroke. 2023 Apr;18(4):433-436. doi: 10.1177/17474930231156081. Epub 2023 Feb 6.
Upper respiratory infections have been suggested as a risk factor for spontaneous cervical artery dissection (sCeAD). If this is the case, public health measures implemented to contain the spread of SARS-CoV-2, which also reduced other communicable diseases such as influenza, might be associated with a reduction in cervical artery dissection incidence.
We determined the incidence of sCeAD before, during and after the COVID-19 pandemic, and the associated public health measures.
All patients suffering an sCeAD and seen in Innsbruck Austria, between January 2002 to December 2016 (pre-COVID comparators) and between January 2020 to August 2022 were recorded through two individual prospective cohort studies. We compared admission rates, demographic, and clinical characteristics of sCeAD patients in pre-COVID-19 and COVID-19 times.
In total, 249 sCeAD patients were admitted prior to the COVID-19 pandemic compared to 20 during its course. Baseline characteristics of sCeAD subjects did not differ in subjects admitted during and prior to the pandemic. Following the introduction of public health measures for the pandemic, there was a marked decrease of sCeAD admissions from 16.5 per year to 6.3 per year (p = 0.012). Since the measures were ended the number of sCeAD admissions increased again. In contrast, the number of all ischemic stroke patients treated at the Medical University of Innsbruck did not alter during the pandemic. (N per year: 633 in 2015, 687 in 2017, 684 in 2019, 731 in 2020, and 717 in 2021).
The incidence of sCeAD fell markedly during the pandemic and this may have resulted from the public health measures introduced and a subsequent reduction in upper respiratory infections. Our study provides indirect evidence for a role of infection in the pathogenesis of sCeAD.
Anonymized data not published within this article will be made available by request from any qualified investigator.
上呼吸道感染被认为是自发性颈内动脉夹层（sCeAD）的危险因素。如果是这样的话，为控制 SARS-CoV-2 传播而实施的公共卫生措施，也减少了流感等其他传染病的传播，可能与颈内动脉夹层发病率的降低有关。
我们确定了 COVID-19 大流行前后 sCeAD 的发病率以及相关的公共卫生措施。
通过两项单独的前瞻性队列研究，记录了 2002 年 1 月至 2016 年 12 月（COVID-19 前对照组）和 2020 年 1 月至 2022 年 8 月期间在奥地利因斯布鲁克因 sCeAD 就诊的所有患者。我们比较了 COVID-19 前和 COVID-19 期间 sCeAD 患者的入院率、人口统计学和临床特征。
在 COVID-19 大流行前，共有 249 例 sCeAD 患者入院，而大流行期间只有 20 例。大流行期间和大流行前入院的 sCeAD 患者的基线特征无差异。在大流行期间采取公共卫生措施后，sCeAD 入院人数从每年 16.5 例显著减少至每年 6.3 例（p=0.012）。自措施结束以来，sCeAD 入院人数再次增加。相比之下，在大流行期间，在因斯布鲁克医科大学接受治疗的所有缺血性脑卒中患者人数没有改变。（每年人数：2015 年为 633 人，2017 年为 687 人，2019 年为 684 人，2020 年为 731 人，2021 年为 717 人）。
大流行期间 sCeAD 的发病率显著下降，这可能是由于实施了公共卫生措施以及随后上呼吸道感染的减少所致。我们的研究为感染在上皮内动脉夹层发病机制中的作用提供了间接证据。
任何合格的研究人员均可根据要求提供未在本文发表的匿名数据。
