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https://doi.org/10.1002/ana.25967
Title: | The Impact of SARS-CoV-2 on Stroke Epidemiology and Care: A Meta-Analysis | Authors: | Katsanos, AH Palaiodimou, L Zand, R Yaghi, S Kamel, H Navi, BB Turc, G Romoli, M Sharma, VK Mavridis, D Shahjouei, S Catanese, L Shoamanesh, A Vadikolias, K Tsioufis, K Lagiou, P Alexandrov, AV Tsiodras, S Tsivgoulis, G |
Keywords: | COVID-19 Case-Control Studies Comorbidity Diabetes Mellitus Hospital Mortality Humans SARS-CoV-2 Stroke Thrombectomy Thrombolytic Therapy |
Issue Date: | 1-Feb-2021 | Publisher: | Wiley | Citation: | Katsanos, AH, Palaiodimou, L, Zand, R, Yaghi, S, Kamel, H, Navi, BB, Turc, G, Romoli, M, Sharma, VK, Mavridis, D, Shahjouei, S, Catanese, L, Shoamanesh, A, Vadikolias, K, Tsioufis, K, Lagiou, P, Alexandrov, AV, Tsiodras, S, Tsivgoulis, G (2021-02-01). The Impact of SARS-CoV-2 on Stroke Epidemiology and Care: A Meta-Analysis. Annals of Neurology 89 (2) : 380-388. ScholarBank@NUS Repository. https://doi.org/10.1002/ana.25967 | Abstract: | 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%, I2 = 87%) were hospitalized for cerebrovascular events, 1.1% (95% CI = 0.8–1.3%, I2 = 85%) for ischemic stroke, and 0.2% (95% CI = 0.1–0.3%, I2 = 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, I2 = 43%) and cryptogenic stroke (OR = 3.98, 95% CI = 1.62–9.77, I2 = 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, I2 = 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, I2 = 0%) or endovascular thrombectomy (OR = 0.78, 95% CI = 0.35–1.74, I2 = 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, I2 = 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 2021;89:380–388. | Source Title: | Annals of Neurology | URI: | https://scholarbank.nus.edu.sg/handle/10635/192248 | ISSN: | 03645134 15318249 |
DOI: | 10.1002/ana.25967 |
Appears in Collections: | Staff Publications Elements |
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