Emergent Large Vessel Occlusion Stroke During New York City's COVID-19 Outbreak Clinical Characteristics and Paraclinical Findings
Emergent Large Vessel Occlusion Stroke During New York City's COVID-19 Outbreak Clinical Characteristics and Paraclinical Findings
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DOI：
10.1161/strokeaha.120.030397
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发表时间：
2020-09-01
期刊：
影响因子：
8.3
通讯作者：
Mocco, J.
中科院分区：
文献类型：
--
作者：
Majidi, Shahram;Fifi, Johanna T.;Mocco, J.
背景和目的：二零一九年新型冠状病毒爆发及其相关疾病（2019冠状病毒病[COVID-19]）已造成全球大流行。早期数据表明，严重COVID-19感染者的缺血性卒中发生率较高。我们评估了紧急大血管闭塞（ELVO）与持续的COVID-19爆发之间是否存在关系。方法：这是一个回顾性、观察性病例系列。数据收集自纽约市西奈山卫生系统医院在COVID-19住院和死亡高峰期3周内出现ELVO的所有患者。从电子病历中提取患者的人口统计学、共病状况、心血管风险因素、COVID-19疾病状态和临床表现。对COVID-19阳性和阴性队列进行了比较。将ELVO中风的发生率与新冠疫情前时期进行比较。结果：45例连续ELVO患者在观察期间出现。53%的患者COVID-19检测呈阳性。总患者的平均（+/- SD）年龄为66（+/- 17）。COVID-19患者明显比非COVID-19患者年轻，分别为59 +/- 13和74 +/- 17（比值比[95% CI]，0.94 [0.81-0.98];P=0.004）。75%的COVID-19患者为男性，而非COVID-19患者为43%（比值比[95% CI]，3.99 [1.12-14.17];P=0.032）。COVID-19患者为白色的可能性较小（8% vs 38% [比值比（95% CI），0.15（0.04-0.81）;P=0.027]）。与COVID-19爆发前的类似持续时间相比，观察到ELVO总数增加了2倍（估计值：0.78 [95% CI，0.47-1.08]，P
Background and Purpose: The 2019 novel coronavirus outbreak and its associated disease (coronavirus disease 2019 [COVID-19]) have created a worldwide pandemic. Early data suggest higher rate of ischemic stroke in severe COVID-19 infection. We evaluated whether a relationship exists between emergent large vessel occlusion (ELVO) and the ongoing COVID-19 outbreak. Methods: This is a retrospective, observational case series. Data were collected from all patients who presented with ELVO to the Mount Sinai Health System Hospitals across New York City during the peak 3 weeks of hospitalization and death from COVID-19. Patients' demographic, comorbid conditions, cardiovascular risk factors, COVID-19 disease status, and clinical presentation were extracted from the electronic medical record. Comparison was made between COVID-19 positive and negative cohorts. The incidence of ELVO stroke was compared with the pre-COVID period. Results: Forty-five consecutive ELVO patients presented during the observation period. Fifty-three percent of patients tested positive for COVID-19. Total patients' mean (+/- SD) age was 66 (+/- 17). Patients with COVID-19 were significantly younger than patients without COVID-19, 59 +/- 13 versus 74 +/- 17 (odds ratio [95% CI], 0.94 [0.81-0.98];P=0.004). Seventy-five percent of patients with COVID-19 were male compared with 43% of patients without COVID-19 (odds ratio [95% CI], 3.99 [1.12-14.17];P=0.032). Patients with COVID-19 were less likely to be White (8% versus 38% [odds ratio (95% CI), 0.15 (0.04-0.81);P=0.027]). In comparison to a similar time duration before the COVID-19 outbreak, a 2-fold increase in the total number of ELVO was observed (estimate: 0.78 [95% CI, 0.47-1.08],P