Atmaca Murat Mert, Bülbül Nazlı Gamze, Ateş Miruna Florentina, Selbest Burcu, Eren Fettah, Güler Sibel, Şimşek Uğur Burak, Yetkin Mehmet Fatih, Akcakoyunlu Merve, Biçer Elif Özge, Kılıç Soner, Yetkin Nur Aleyna, Taş Şazimet, Kocakaya Zeynep, Karasu Kevser, Yüksel Ufuk, Kılıç Ayşegül Ulu, Yüce Zeynep Türe, Tutar Nuri, Ketencioğlu Burcu Baran, Gündoğan Kürşat, Temel Şahin, Hasan Murad Al, Benli Şeyma, Eröz Çağla, Öztürk Ahmet, Erdoğan Füsun Ferda
Sultan 2.Abdulhamid Khan Training and Research Hospital Neurology Clinic, Turkey.
Maltepe University, Faculty of Medicine, Department of Neurology, Turkey.
Noro Psikiyatr Ars. 2024 Jul 24;67(3):241-247. doi: 10.29399/npa.28493. eCollection 2024.
Acute ischemic stroke (AIS) is a devastating complication of COVID-19 with high morbidity and mortality. In this study, we reported the frequency, characteristics, and outcome of AIS in patients with COVID-19.
This multicenter and cross-sectional study was conducted between April 2020 and February 2021. Among the hospitalized patients with COVID-19, the detailed characteristics of those with and without AIS were recorded and compared.
Six hundred ninety-three patients were included in the study. Acute ischemic stroke was detected in 16 (2.31%) patients, the median age was 77 (range, 48-91) years, and 10 (62.5%) were female. The median NIHSS score at admission was 9 (range, 3-17). Total anterior circulation infarction (TACI) was the most common (37.5%) type and cardioembolism was the most common etiology (37.5%). Nine patients (56.25%) developed AIS within 24 hours of having COVID-19. COVID-19 severity was severe or critical in seven patients (43.75%). Eight patients died, and eight were discharged. Patients with AIS had a higher rate of hypertension, coronary artery disease, heart failure, a history of myocardial infarction, a history of cerebrovascular disease, severe and critical COVID-19, a higher mean age, and a longer ICU stay compared with those without AIS (p<0.001 for each).
AIS can occur in patients with COVID-19 and is associated with mortality. Acute ischemic stroke is encountered at any stage of COVID-19, especially within the first 72 hours of the diagnosis, in older patients with comorbidities and severe COVID-19. There is an increased risk of AIS in patients with COVID-19 with a history of stroke.
急性缺血性卒中（AIS）是新型冠状病毒肺炎（COVID-19）的一种毁灭性并发症，发病率和死亡率都很高。在本研究中，我们报告了COVID-19患者中AIS的发生率、特征和结局。
本多中心横断面研究于2020年4月至2021年2月进行。在住院的COVID-19患者中，记录并比较了有和没有AIS患者的详细特征。
693例患者纳入本研究。16例（2.31%）患者检测出急性缺血性卒中，中位年龄为77岁（范围48-91岁），10例（62.5%）为女性。入院时美国国立卫生研究院卒中量表（NIHSS）评分中位数为9分（范围3-17分）。完全前循环梗死（TACI）是最常见的类型（37.5%），心源性栓塞是最常见的病因（37.5%）。9例（56.25%）患者在感染COVID-19后24小时内发生AIS。7例（43.75%）患者的COVID-19病情为重度或危重度。8例患者死亡，8例出院。与没有AIS的患者相比，AIS患者的高血压、冠状动脉疾病、心力衰竭、心肌梗死病史、脑血管疾病病史、COVID-19重度和危重度发生率更高，平均年龄更大，入住重症监护病房（ICU）的时间更长（每项p<0.001）。
COVID-19患者可发生AIS并与死亡率相关。在COVID-19的任何阶段均可发生急性缺血性卒中，尤其是在诊断后的前72小时内，在合并症的老年患者和COVID-19重症患者中更为常见。有卒中病史的COVID-19患者发生AIS的风险增加。
