The Impact of SARS-CoV-2 on Stroke Epidemiology and Care: A Meta-Analysis

被引：0

作者：

Katsanos, Aristeidis H. ^{[1
,2
]}

Palaiodimou, Lina ^{[2
]}

Zand, Ramin ^{[3
]}

Yaghi, Shadi ^{[4
]}

Kamel, Hooman ^{[5
,6
]}

Navi, Babak B. ^{[5
,6
]}

Turc, Guillaume ^{[7
,8
,9
,10
]}

Romoli, Michele ^{[11
,12
]}

Sharma, Vijay K. ^{[13
,14
]}

Mavridis, Dimitris ^{[15
,16
]}

Shahjouei, Shima ^{[3
]}

Catanese, Luciana ^{[1
]}

Shoamanesh, Ashkan ^{[1
]}

Vadikolias, Konstantinos ^{[17
,18
]}

Tsioufis, Konstantinos ^{[18
]}

Lagiou, Pagona ^{[19
,20
]}

Alexandrov, Andrei V. ^{[21
]}

Tsiodras, Sotirios ^{[22
,23
]}

Tsivgoulis, Georgios ^{[2
]}

机构：

[1] McMaster Univ, Div Neurol, Populat Hlth Res Inst, Hamilton, ON, Canada

[2] Natl & Kapodistrian Univ Athens, Sch Med, Attikon Hosp, Dept Neurol 2, Athens, Greece

[3] Geisinger Hlth Syst, Neurosci Inst, Danville, PA USA

[4] NYU Langone Hlth, Dept Neurol, New York, NY USA

[5] Weill Cornell Med, Clin & Translat Neurosci Unit, Feil Family Brain & Mind Res Inst, New York, NY USA

[6] Weill Cornell Med, Dept Neurol, New York, NY USA

[7] St Anne Hosp, Paris Psychiat & Neurosci Univ Hosp Grp, Dept Neurol, Paris, France

[8] Univ Paris, Paris, France

[9] INSERM, U1266, Paris, France

[10] FHU Neurovasc, Paris, France

[11] Maurizio Bufalini Hosp, Neurol Unit, Cesena, Italy

[12] Univ Perugia, Neurol Clin, S Maria Misericordia Hosp, Perugia, Italy

[13] Natl Univ Singapore Hosp, Dept Med, Div Neurol, Singapore, Singapore

[14] Natl Univ Singapore, Sch Med, Singapore, Singapore

[15] Univ Ioannina, Dept Primary Educ, Ioannina, Greece

[16] Paris Descartes Univ, Fac Med, Paris, France

[17] Democritus Univ Thrace, Sch Med, Dept Neurol, Alexandroupolis, Greece

[18] Natl & Kapodistrian Univ Athens, Med Sch, Hippokrat Hosp, Dept Cardiol 1, Athens, Greece

[19] Natl & Kapodistrian Univ Athens, Sch Med, Dept Hyg Epidemiol & Med Stat, Athens, Greece

[20] Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA

[21] Univ Tennessee, Ctr Hlth Sci, Dept Neurol, Memphis, TN 38163 USA

[22] Natl & Kapodistrian Univ Athens, Attikon Univ Hosp, Dept Internal Med 4, Athens, Greece

[23] Natl Publ Hlth Org Greece, Athens, Greece

来源：

ANNALS OF NEUROLOGY | 2021年 / 89卷 / 02期

关键词：

COVID-19; COMPLICATIONS;

D O I：

10.1002/ana.25967

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective Emerging data indicate an increased risk of cerebrovascular events with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and highlight the potential impact of coronavirus disease (COVID-19) on the management and outcomes of acute stroke. We conducted a systematic review and meta-analysis to evaluate the aforementioned considerations. Methods We performed a meta-analysis of observational cohort studies reporting on the occurrence and/or outcomes of patients with cerebrovascular events in association with their SARS-CoV-2 infection status. We used a random-effects model. Summary estimates were reported as odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Results We identified 18 cohort studies including 67,845 patients. Among patients with SARS-CoV-2, 1.3% (95% CI = 0.9-1.6%, I-2 = 87%) were hospitalized for cerebrovascular events, 1.1% (95% CI = 0.8-1.3%, I-2 = 85%) for ischemic stroke, and 0.2% (95% CI = 0.1-0.3%, I-2 = 64%) for hemorrhagic stroke. Compared to noninfected contemporary or historical controls, patients with SARS-CoV-2 infection had increased odds of ischemic stroke (OR = 3.58, 95% CI = 1.43-8.92, I-2 = 43%) and cryptogenic stroke (OR = 3.98, 95% CI = 1.62-9.77, I-2 = 0%). Diabetes mellitus was found to be more prevalent among SARS-CoV-2 stroke patients compared to noninfected historical controls (OR = 1.39, 95% CI = 1.00-1.94, I-2 = 0%). SARS-CoV-2 infection status was not associated with the likelihood of receiving intravenous thrombolysis (OR = 1.42, 95% CI = 0.65-3.10, I-2 = 0%) or endovascular thrombectomy (OR = 0.78, 95% CI = 0.35-1.74, I-2 = 0%) among hospitalized ischemic stroke patients during the COVID-19 pandemic. Odds of in-hospital mortality were higher among SARS-CoV-2 stroke patients compared to noninfected contemporary or historical stroke patients (OR = 5.60, 95% CI = 3.19-9.80, I-2 = 45%). Interpretation SARS-CoV-2 appears to be associated with an increased risk of ischemic stroke, and potentially cryptogenic stroke in particular. It may also be related to an increased mortality risk. ANN NEUROL 2020

引用

页码：380 / 388

页数：9

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