Davis Monique G, Gangu Karthik, Suriya Sajid, Maringanti Babu Sriram, Chourasia Prabal, Bobba Aniesh, Tripathi Alok, Avula Sindhu Reddy, Shekhar Rahul, Sheikh Abu Baker
Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA.
Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA.
J Clin Med. 2023 Feb 8;12(4):1340. doi: 10.3390/jcm12041340.
Coronavirus-19, primarily a respiratory virus, also affects the nervous system. Acute ischemic stroke (AIS) is a well-known complication among COVID-19 infections, but large-scale studies evaluating AIS outcomes related to COVID-19 infection remain limited. We used the National Inpatient Sample database to compare acute ischemic stroke patients with and without COVID-19. A total of 329,240 patients were included in the study: acute ischemic stroke with COVID-19 ( = 6665, 2.0%) and acute ischemic stroke without COVID-19 ( = 322,575, 98.0%). The primary outcome was in-hospital mortality. Secondary outcomes included mechanical ventilation, vasopressor use, mechanical thrombectomy, thrombolysis, seizure, acute venous thromboembolism, acute myocardial infarction, cardiac arrest, septic shock, acute kidney injury requiring hemodialysis, length of stay, mean total hospitalization charge, and disposition. Acute ischemic stroke patients who were COVID-19-positive had significantly increased in-hospital mortality compared to acute ischemic stroke patients without COVID-19 (16.9% vs. 4.1%, aOR: 2.5 [95% CI 1.7-3.6], < 0.001). This cohort also had significantly increased mechanical ventilation use, acute venous thromboembolism, acute myocardial infarction, cardiac arrest, septic shock, acute kidney injury, length of stay, and mean total hospitalization charge. Further research regarding vaccination and therapies will be vital in reducing worse outcomes in patients with acute ischemic stroke and COVID-19.
新型冠状病毒肺炎（Coronavirus-19）主要是一种呼吸道病毒，也会影响神经系统。急性缺血性卒中（AIS）是新型冠状病毒肺炎感染中一种众所周知的并发症，但评估与新型冠状病毒肺炎感染相关的急性缺血性卒中结局的大规模研究仍然有限。我们使用国家住院样本数据库比较了患有和未患有新型冠状病毒肺炎的急性缺血性卒中患者。共有329240名患者纳入研究：患有新型冠状病毒肺炎的急性缺血性卒中患者（n = 6665，2.0%）和未患有新型冠状病毒肺炎的急性缺血性卒中患者（n = 322575，98.0%）。主要结局是住院死亡率。次要结局包括机械通气、血管活性药物使用、机械取栓、溶栓、癫痫发作、急性静脉血栓栓塞、急性心肌梗死、心脏骤停、感染性休克、需要血液透析的急性肾损伤、住院时间、平均总住院费用和出院情况。与未患有新型冠状病毒肺炎的急性缺血性卒中患者相比，新型冠状病毒肺炎检测呈阳性的急性缺血性卒中患者的住院死亡率显著增加（16.9%对4.1%，调整后比值比：2.5 [95%置信区间1.7 - 3.6]，P < 0.001）。该队列的机械通气使用、急性静脉血栓栓塞、急性心肌梗死、心脏骤停、感染性休克、急性肾损伤、住院时间和平均总住院费用也显著增加。关于疫苗接种和治疗的进一步研究对于降低急性缺血性卒中和新型冠状病毒肺炎患者的不良结局至关重要。
