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Clinical characteristics and admission patterns of stroke patients during the COVID 19 pandemic: A single center retrospective, observational study from the Abu Dhabi, United Arab Emirates
Clinical Neurology and Neurosurgery ( IF 1.8 ) Pub Date : 2020-12-01 , DOI: 10.1016/j.clineuro.2020.106227
Seby John 1 , Syed Irteza Hussain 1 , Bartlomiej Piechowski-Jozwiak 2 , Jamil Dibu 3 , Praveen Kesav 2 , Ahmad Bayrlee 3 , Hussam Elkambergy 3 , Terrence Lee St John 4 , Florian Roser 5 , Victoria Ann Mifsud 2
Affiliation  

Objective: To compare ischemic and hemorrhagic stroke patients with COVID-19 to non-COVID-19 controls, and to describe changes in stroke admission patterns during the pandemic. Methods:This is a single center, retrospective, observational study. All consecutive patients admitted with primary diagnosis of ischemic/ hemorrhagic stroke between March1st -May10th 2020 were included and compared with the same time period in 2019. Results: There was a 41.9% increase in stroke admissions in 2020 (148 vs 210,P = .001). When comparing all ischemic strokes, higher rate of large vessel occlusion (LVO) (18.3% vs 33.8%,P = .008) and significant delay in initiation of mechanical thrombectomy after hospital arrival (67.75 vs 104.30 minutes,P = .001) was observed in 2020. When comparing all hemorrhagic strokes, there were no differences between the two years. Among 591 COVID-19 admissions, 31 (5.24%) patients with stroke including 19 with ischemic (3.21%) and 12 with hemorrhagic stroke (2.03%) were identified. Patients with COVID-19 and ischemic stroke were significantly younger (58.74 vs 48.11 years,P = .002), predominantly male (68.18% vs 94.74%,P = .016), had lesser vascular risk factors, had more severe clinical presentation (NIHSS 7.01 vs 17.05,P < .001), and higher rate of LVO (23.6% vs. 63.1%,P = .006). There was no difference in the rate of endovascular thrombectomy, but time to groin puncture was significantly longer in COVID-19 patients (83.41 vs 129.50 minutes,P = .003). For hemorrhagic stroke, COVID-19 patients did not differ from non-COVID-19 patients. Conclusions: Stroke continues to occur during this pandemic and stroke pathways have been affected by the pandemic. Stroke occurs in approximately 5% of patients with COVID-19. COVID-19 associated ischemic stroke occurs in predominantly male patients who are younger, with fewer vascular risk factors, can be more severe, and have higher rates of LVO. Despite an increase in LVO during the pandemic, treatment with mechanical thrombectomy has not increased. COVID-19 associated hemorrhagic stroke does not differ from non-COVID-19 hemorrhagic stroke patients.

中文翻译:

COVID 19 大流行期间中风患者的临床特征和入院模式:来自阿拉伯联合酋长国阿布扎比的单中心回顾性观察研究

目的:比较患有 COVID-19 的缺血性和出血性中风患者与非 COVID-19 对照患者,并描述大流行期间中风入院模式的变化。方法:这是一项单中心、回顾性、观察性研究。纳入 2020 年 3 月 1 日至 5 月 10 日期间首次诊断为缺血性/出血性卒中的所有连续患者,并与 2019 年同期进行比较。结果:2020 年卒中入院人数增加了 41.9%(148 例 vs 210 例,P = . 001)。比较所有缺血性卒中时,大血管闭塞 (LVO) 发生率较高(18.3% vs 33.8%,P = .008),入院后机械血栓切除术开始显着延迟(67.75 分钟 vs 104.30 分钟,P = .001) 2020 年观察到。比较所有出血性中风时,两年之间没有差异。在 591 名入院的 COVID-19 患者中,确定了 31 名(5.24%)中风患者,其中 19 名缺血性中风(3.21%)和 12 名出血性中风(2.03%)。COVID-19 合并缺血性卒中患者明显更年轻(58.74 岁 vs 48.11 岁,P = .002),主要为男性(68.18% vs 94.74%,P = .016),血管危险因素较少,临床表现更严重( NIHSS 7.01 vs. 17.05,P < .001),以及较高的 LVO 发生率(23.6% vs. 63.1%,P = .006)。血管内取栓率没有差异,但 COVID-19 患者的腹股沟穿刺时间明显更长(83.41 分钟 vs 129.50 分钟,P = .003)。对于出血性中风,COVID-19 患者与非 COVID-19 患者没有差异。结论:本次大流行期间脑卒中继续发生,脑卒中通路也受到了大流行的影响。大约 5% 的 COVID-19 患者会发生中风。COVID-19 相关的缺血性中风主要发生在男性患者中,他们年龄较小,血管危险因素较少,病情可能更严重,且 LVO 发生率较高。尽管大流行期间 LVO 有所增加,但机械取栓治疗并未增加。COVID-19 相关的出血性中风与非 COVID-19 出血性中风患者没有区别。
更新日期:2020-12-01
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