Acute Ischemic Stroke in Patients with COVID-19: An Analysis from Get with the Guidelines-Stroke

Pratyaksh K. Srivastava, Shuaiqi Zhang, Ying Xian, Hanzhang Xu, Christine Rutan, Heather M. Alger, Jason Walchok, Joseph Williams, James A. De Lemos, Marquita R. Decker-Palmer, Brooke Alhanti, Mitchell S.V. Elkind, Steve R. Messé, Eric E. Smith, Lee H. Schwamm, Gregg C. Fonarow

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background and Purpose: Studies suggest an increased risk of adverse outcomes among patients with acute ischemic stroke (AIS) and coronavirus disease 2019 (COVID-19). Methods: Using Get With The Guidelines-Stroke, we identified 41 971 patients (AIS/COVID-19: 1143; AIS/no COVID-19: 40 828) with AIS hospitalized between February 4, 2020 and June 29, 2020, from 458 Get With The Guidelines-Stroke hospitals with at least one COVID-19 case and evaluated clinical characteristics, treatment patterns, and outcomes. Results: Compared with patients with AIS/no COVID-19, those with AIS/COVID-19 were younger, more likely to be non-Hispanic Black, Hispanic, or Asian, more likely to present with higher National Institutes of Health Stroke Scale scores, and had greater proportions of large vessel occlusions. Rates of thrombolysis and thrombectomy were similar between the groups. Door to computed tomography (median 55 [18-207] versus 35 [14-99] minutes, P<0.001), door to needle (59 [40-82] versus 46 [33-64] minutes, P<0.001), and door to endovascular therapy (114 [74-169] versus 90 [54-133] minutes, P=0.002) times were longer in the AIS/COVID-19 cohort. In adjusted models, patients with AIS/COVID-19 had decreased odds of discharge with modified Rankin Scale score of ≤2 (odds ratio, 0.65 [95% CI, 0.52-0.81], P<0.001) and increased odds of in-hospital mortality (odds ratio, 4.34 [95% CI, 3.48-5.40], P<0.001). ConclusionS: This analysis demonstrates younger age, greater stroke severity, longer times to evaluation and treatment, and worse morbidity and mortality in patients with AIS/COVID-19 compared with those with AIS/no COVID-19.

Original languageEnglish (US)
Pages (from-to)1826-1829
Number of pages4
JournalStroke
DOIs
StateAccepted/In press - 2021

Keywords

  • coronavirus
  • COVID-19
  • hospital
  • ischemic stroke
  • mortality

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

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