Department of Neurology, University of Health Sciences, Bursa Faculty of Medicine, Bursa City Hospital, Bursa, Turkey.
Department of Neurology, University of Health Sciences, Bursa Faculty of Medicine, Bursa City Hospital, Bursa, Turkey.
Clin Neurol Neurosurg. 2024 Jul;242:108324. doi: 10.1016/j.clineuro.2024.108324. Epub 2024 May 9.
We aimed to compare the radiological and clinical characteristics of COVID-19-positive and -negative acute ischemic stroke (AIS) patients who underwent revascularization and to evaluate whether COVID-19 has an effect on revascularization and outcome in AIS patients with COVID-19 infection.
Consecutive COVID-19 positive and negative AIS patients who underwent intravenous thrombolysis and/or endovascular therapy in our hospital between March 2020 and February 2022 were included in this study. Our study is retrospective and 23 COVID-19 positive patients and 108 COVID-19 negative patients were compared in terms of radiological and clinical characteristics.
Hypertension was lower in the COVID-19 positive ischemic stroke group (p=0.029). Admission NIHSS score was higher in COVID-19 positive patients (p=0.041). ASPECTS was found to be lower in COVID-19 positive ischemic stroke patients (p=0.019). The rate of hyperdense artery sign differed between groups (p=0.014) and was higher in the COVID-19 positive ischemic stroke group. The incidence of multi-vessel occlusion was found to be significantly higher in the COVID-19-positive ischemic stroke group (p=0.002). In terms of prognostic features, only the 3-month good outcome rate was statistically significantly lower in the COVID-19-positive ischemic stroke group (p=0.011).
This study found that radiologically, COVID-19 may be associated with lower ASPECTS in ischemic stroke patients receiving revascularization treatment and may predispose to multivessel occlusion and hyperdense artery sign. Clinically, COVID-19 may be associated with a more severe initial presentation and worse prognosis at 3 months in ischemic stroke patients undergoing revascularization, but may not affect long-term mortality.
比较 COVID-19 阳性和阴性急性缺血性卒中（AIS）患者接受血管再通治疗的影像学和临床特征，并评估 COVID-19 对 COVID-19 感染 AIS 患者血管再通和结局的影响。
本研究纳入 2020 年 3 月至 2022 年 2 月期间在我院接受静脉溶栓和/或血管内治疗的连续 COVID-19 阳性和阴性 AIS 患者。本研究为回顾性研究，比较了 23 例 COVID-19 阳性患者和 108 例 COVID-19 阴性患者的影像学和临床特征。
COVID-19 阳性缺血性卒中组高血压发生率较低（p=0.029）。COVID-19 阳性患者入院 NIHSS 评分较高（p=0.041）。COVID-19 阳性缺血性卒中患者 ASPECTS 评分较低（p=0.019）。COVID-19 阳性缺血性卒中组高密度动脉征的发生率存在差异（p=0.014），且阳性率较高。COVID-19 阳性缺血性卒中组多血管闭塞的发生率明显较高（p=0.002）。在预后特征方面，COVID-19 阳性缺血性卒中组 3 个月时良好结局率明显较低（p=0.011）。
本研究发现，COVID-19 可能与接受血管再通治疗的缺血性卒中患者的 ASPECTS 较低有关，并且可能易导致多血管闭塞和高密度动脉征。临床方面，COVID-19 可能与血管再通的缺血性卒中患者初始表现更严重，3 个月预后更差有关，但可能不影响长期死亡率。
