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Jurkevičienė J, Vaišvilas M, Masiliūnas R, Matijošaitis V, Vaitkus A, Geštautaitė D, Taroza S, Puzinas P, Galvanauskaitė E, Jatužis D, Vilionskis A. Reperfusion Therapies for Acute Ischemic Stroke in COVID-19 Patients: A Nationwide Multi-Center Study. J Clin Med 2022; 11:jcm11113004. [PMID: 35683393 PMCID: PMC9181080 DOI: 10.3390/jcm11113004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/18/2022] [Accepted: 05/23/2022] [Indexed: 12/07/2022] Open
Abstract
(1) Background: Acute ischemic stroke (AIS) is a possible complication of the coronavirus disease 2019 (COVID-19). Safety and efficacy data on reperfusion therapies (RT)—intravenous thrombolysis and endovascular treatment (EVT)—in stroke patients with COVID-19 is lacking. (2) Methods: We performed a retrospective nationwide multi-center pair-matched analysis of COVID-19 patients with AIS who underwent RT. We included adult COVID-19 patients with AIS who were treated with RT between 16 March 2020 and 30 June 2021. All subjects were paired with non-infected controls, matched for age, sex, stroke arterial vascular territory, and RT modality. The primary outcome measure was a favorable functional outcome defined by the modified Rankin scale (mRS 0–2). (3) Results: Thirty-one subjects and thirty-one matched controls were included. The median baseline National Institutes of Health Stroke Scale (NIHSS) score was higher in the COVID-19 group (16 vs. 12, p = 0.028). Rates of ischemic changes and symptomatic intracerebral hemorrhages did not differ significantly between the two groups at 24 h after RT. The median NIHSS 24 h after reperfusion remained significantly higher in the COVID-19 group (16 vs. 5, p = 0.003). MRS 0–2 at discharge was significantly less common in COVID-19 patients (22.6% vs. 51.8%, p = 0.018). Three-month mortality was 54.8% in the COVID-19 group versus 12.9% in controls (p = 0.001). (4) Conclusion: Reperfusion therapies on AIS in COVID-19 patients appear to be safe; however, functional outcomes are significantly worse, and 3-month mortality is higher.
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Affiliation(s)
- Justina Jurkevičienė
- Stroke Centre, Republican Vilnius University Hospital, 04130 Vilnius, Lithuania;
- Correspondence:
| | - Mantas Vaišvilas
- Stroke Centre, Republican Vilnius University Hospital, 04130 Vilnius, Lithuania;
| | - Rytis Masiliūnas
- Center of Neurology, Vilnius University, 08661 Vilnius, Lithuania; (R.M.); (D.J.)
| | - Vaidas Matijošaitis
- Department of Neurology, Lithuanian University of Health Sciences, 50009 Kaunas, Lithuania; (V.M.); (A.V.); (D.G.)
| | - Antanas Vaitkus
- Department of Neurology, Lithuanian University of Health Sciences, 50009 Kaunas, Lithuania; (V.M.); (A.V.); (D.G.)
| | - Dovilė Geštautaitė
- Department of Neurology, Lithuanian University of Health Sciences, 50009 Kaunas, Lithuania; (V.M.); (A.V.); (D.G.)
| | - Saulius Taroza
- Laboratory of Behavioral Medicine (Palanga), Neuroscience Institute, Lithuanian University of Health Sciences, 00135 Palanga, Lithuania;
| | - Paulius Puzinas
- Department of Neurology, Republican Panevėžys Hospital, 35144 Panevėžys, Lithuania;
| | - Erika Galvanauskaitė
- Department of Neurology, Republican Šiauliai Hospital, 76231 Šiauliai, Lithuania;
| | - Dalius Jatužis
- Center of Neurology, Vilnius University, 08661 Vilnius, Lithuania; (R.M.); (D.J.)
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