Background and Purpose:We evaluated whether stroke severity, functional outcome, and mortality are different in patients with ischemic stroke with or without coronavirus disease 2019 (COVID-19) infection.Methods:A prospective, observational, multicentre cohort study in Catalonia, Spain. Recruitment was consecutive from mid-March to mid-May 2020. Patients had an acute ischemic stroke within 48 hours and a previous modified Rankin Scale (mRS) score of 0 to 3. We collected demographic data, vascular risk factors, prior mRS score, National Institutes of Health Stroke Scale score, rate of reperfusion therapies, logistics, and metrics. Primary end point was functional outcome at 3 months. Favourable outcome was defined depending on the previous mRS score. Secondary outcome was mortality at 3 months. We performed mRS shift and multivariable analyses.Results:We evaluated 701 patients (mean age 72.3±13.3 years, 60.5% men) and 91 (13%) had COVID-19 infection. Median baseline National Institutes of Health Stroke Scale score was higher in patients with COVID-19 compared with patients without COVID-19 (8 [3–18] versus 6 [2–14], P=0.049). Proportion of patients with a favourable functional outcome was 33.7% in the COVID-19 and 47% in the non-COVID-19 group. However, after a multivariable logistic regression analysis, COVID-19 infection did not increase the probability of unfavourable functional outcome. Mortality rate was 39.3% among patients with COVID-19 and 16.1% in the non-COVID-19 group. In the multivariable logistic regression analysis, COVID-19 infection was a risk factor for mortality (hazard ratio, 3.14 [95% CI, 2.10–4.71]; P<0.001).Conclusions:Patients with ischemic stroke and COVID-19 infection have more severe strokes and a higher mortality than patients with stroke without COVID-19 infection. However, functional outcome is comparable in both groups.

中文翻译：

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COVID-19 感染对缺血性卒中患者预后的影响

背景和目的：我们评估了有或没有冠状病毒病 2019 (COVID-19) 感染的缺血性卒中患者的卒中严重程度、功能结果和死亡率是否不同。方法：在西班牙加泰罗尼亚进行的一项前瞻性、观察性、多中心队列研究。招募是从 2020 年 3 月中旬到 5 月中旬连续进行的。患者在 48 小时内发生急性缺血性卒中，之前的改良 Rankin 量表 (mRS) 评分为 0 至 3。我们收集了人口统计学数据、血管危险因素、既往 mRS 评分、美国国立卫生研究院卒中量表评分、再灌注治疗率、物流和指标。主要终点是 3 个月时的功能结果。有利结果的定义取决于先前的 mRS 评分。次要结果是 3 个月时的死亡率。我们进行了 mRS 偏移和多变量分析。结果：我们评估了 701 名患者（平均年龄 72.3±13.3 岁，60.5% 男性）和 91 名（13%）感染 COVID-19。与没有 COVID-19 的患者相比，患有 COVID-19 的患者的美国国立卫生研究院卒中量表评分中位数更高（8 [3-18] 比 6 [2-14]，P = 0.049）。在 COVID-19 和非 COVID-19 组中，功能结果良好的患者比例分别为 33.7% 和 47%。然而，经过多变量逻辑回归分析，COVID-19 感染并没有增加不良功能结果的可能性。COVID-19 患者的死亡率为 39.3%，非 COVID-19 组的死亡率为 16.1%。在多变量逻辑回归分析中，COVID-19 感染是死亡的危险因素（风险比，3.14 [95% CI，2.10–4.71]；P <0.001）。结论：缺血性卒中和 COVID-19 感染患者的死亡率更高严重中风，死亡率高于未感染 COVID-19 的中风患者。然而，两组的功能结果具有可比性。