TY - JOUR
T1 - International controlled study of revascularization and outcomes following COVID-positive mechanical thrombectomy
AU - North American Neurovascular COVID-19 (NAN-C) Consortium & Society of Vascular and Interventional Neurology (SVIN) Investigators
AU - Dmytriw, Adam A.
AU - Ghozy, Sherief
AU - Sweid, Ahmad
AU - Piotin, Michel
AU - Bekelis, Kimon
AU - Sourour, Nader
AU - Raz, Eytan
AU - Vela-Duarte, Daniel
AU - Linfante, Italo
AU - Dabus, Guilherme
AU - Kole, Max
AU - Martínez-Galdámez, Mario
AU - Nimjee, Shahid M.
AU - Lopes, Demetrius K.
AU - Hassan, Ameer E.
AU - Kan, Peter
AU - Ghorbani, Mohammad
AU - Levitt, Michael R.
AU - Escalard, Simon
AU - Missios, Symeon
AU - Shapiro, Maksim
AU - Clarençon, Fréderic
AU - Elhorany, Mahmoud
AU - Tahir, Rizwan A.
AU - Youssef, Patrick P.
AU - Pandey, Aditya S.
AU - Starke, Robert M.
AU - El Naamani, Kareem
AU - Abbas, Rawad
AU - Mansour, Ossama Y.
AU - Galvan, Jorge
AU - Billingsley, Joshua T.
AU - Mortazavi, Abolghasem
AU - Walker, Melanie
AU - Dibas, Mahmoud
AU - Settecase, Fabio
AU - Heran, Manraj K.S.
AU - Kuhn, Anna L.
AU - Puri, Ajit S.
AU - Menon, Bijoy K.
AU - Sivakumar, Sanjeev
AU - Mowla, Ashkan
AU - D'Amato, Salvatore
AU - Zha, Alicia M.
AU - Cooke, Daniel
AU - Vranic, Justin E.
AU - Regenhardt, Robert W.
AU - Rabinov, James D.
AU - Tutino, Vincent
AU - Siddiqui, Adnan
N1 - Publisher Copyright:
© 2022 European Academy of Neurology.
PY - 2022/11
Y1 - 2022/11
N2 - Background and purpose: Previous studies suggest that mechanisms and outcomes in patients with COVID-19-associated stroke differ from those in patients with non-COVID-19-associated strokes, but there is limited comparative evidence focusing on these populations. The aim of this study, therefore, was to determine if a significant association exists between COVID-19 status with revascularization and functional outcomes following thrombectomy for large vessel occlusion (LVO), after adjustment for potential confounding factors. Methods: A cross-sectional, international multicenter retrospective study was conducted in consecutively admitted COVID-19 patients with concomitant acute LVO, compared to a control group without COVID-19. Data collected included age, gender, comorbidities, clinical characteristics, details of the involved vessels, procedural technique, and various outcomes. A multivariable-adjusted analysis was conducted. Results: In this cohort of 697 patients with acute LVO, 302 had COVID-19 while 395 patients did not. There was a significant difference (p < 0.001) in the mean age (in years) and gender of patients, with younger patients and more males in the COVID-19 group. In terms of favorable revascularization (modified Thrombolysis in Cerebral Infarction [mTICI] grade 3), COVID-19 was associated with lower odds of complete revascularization (odds ratio 0.33, 95% confidence interval [CI] 0.23–0.48; p < 0.001), which persisted on multivariable modeling with adjustment for other predictors (adjusted odds ratio 0.30, 95% CI 0.12–0.77; p = 0.012). Moreover, endovascular complications, in-hospital mortality, and length of hospital stay were significantly higher among COVID-19 patients (p < 0.001). Conclusion: COVID-19 was an independent predictor of incomplete revascularization and poor functional outcome in patients with stroke due to LVO. Furthermore, COVID-19 patients with LVO were more often younger and had higher morbidity/mortality rates.
AB - Background and purpose: Previous studies suggest that mechanisms and outcomes in patients with COVID-19-associated stroke differ from those in patients with non-COVID-19-associated strokes, but there is limited comparative evidence focusing on these populations. The aim of this study, therefore, was to determine if a significant association exists between COVID-19 status with revascularization and functional outcomes following thrombectomy for large vessel occlusion (LVO), after adjustment for potential confounding factors. Methods: A cross-sectional, international multicenter retrospective study was conducted in consecutively admitted COVID-19 patients with concomitant acute LVO, compared to a control group without COVID-19. Data collected included age, gender, comorbidities, clinical characteristics, details of the involved vessels, procedural technique, and various outcomes. A multivariable-adjusted analysis was conducted. Results: In this cohort of 697 patients with acute LVO, 302 had COVID-19 while 395 patients did not. There was a significant difference (p < 0.001) in the mean age (in years) and gender of patients, with younger patients and more males in the COVID-19 group. In terms of favorable revascularization (modified Thrombolysis in Cerebral Infarction [mTICI] grade 3), COVID-19 was associated with lower odds of complete revascularization (odds ratio 0.33, 95% confidence interval [CI] 0.23–0.48; p < 0.001), which persisted on multivariable modeling with adjustment for other predictors (adjusted odds ratio 0.30, 95% CI 0.12–0.77; p = 0.012). Moreover, endovascular complications, in-hospital mortality, and length of hospital stay were significantly higher among COVID-19 patients (p < 0.001). Conclusion: COVID-19 was an independent predictor of incomplete revascularization and poor functional outcome in patients with stroke due to LVO. Furthermore, COVID-19 patients with LVO were more often younger and had higher morbidity/mortality rates.
KW - COVID-19
KW - large vessel occlusion
KW - morbidity
KW - mortality
KW - stroke
UR - https://www.scopus.com/pages/publications/85135016858
U2 - 10.1111/ene.15493
DO - 10.1111/ene.15493
M3 - Article
C2 - 35818781
AN - SCOPUS:85135016858
SN - 1351-5101
VL - 29
SP - 3273
EP - 3287
JO - European Journal of Neurology
JF - European Journal of Neurology
IS - 11
ER -