Poor Outcomes Common With COVID-19, Acute Ischemic Stroke

Factors associated with poor functional outcomes included age older than 60 years, diabetes mellitus, increased NIHSS, LVO
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FRIDAY, Feb. 18, 2022 (HealthDay News) -- About half of patients with COVID-19 with acute ischemic stroke (AIS) have poor outcomes, with 38.8 percent mortality, according to a study recently published in the Journal of Neurology, Neurosurgery & Psychiatry.

Adam A. Dmytriw, M.D., M.P.H., from Massachusetts General Hospital in Boston, and colleagues examined the clinical characteristics of COVID-19 with AIS in a multicenter study involving patients who presented between March 14 and Aug. 30, 2020. Poor functional outcome, defined as a modified Rankin Scale of 5 or 6 at discharge was assessed as the primary end point. Data were included for 230 COVID-19 patients with AIS: 67 and 33 percent were older and younger than 60 years, respectively.

The researchers found that about 50.2 percent of the patients had poor outcomes, with a 38.8 percent observed mortality rate. At presentation, the median National Institutes of Health Stroke Scale (NIHSS) was 12.0, and 42.8 percent of the patients presented with large vessel occlusion (LVO). Factors significantly associated with poor functional outcome included age older than 60 years, diabetes mellitus, increased NIHSS at admission, LVO, and no intravenous tissue plasminogen activator (adjusted odds ratios, 4.60, 2.53, 1.10, 3.02, and 2.76, respectively).

"There is an interaction that is still unknown between COVID respiratory disease and stroke, because the rate of poor outcomes or mortality is clearly greater than it would be in someone who had just an acute respiratory distress syndrome or COVID pneumonia, and also worse than someone who would have an equivalently large stroke in the pre-COVID era," Dmytriw said in a statement.

Abstract/Full Text

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