Comparison of stroke care parameters in acute ischemic stroke patients with and without concurrent Covid-19. A Nationwid
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(2020) 2:48
LETTER TO THE EDITOR
Neurological Research and Practice
Open Access
Comparison of stroke care parameters in acute ischemic stroke patients with and without concurrent Covid-19. A Nationwide analysis Daniel Richter1, Christos Krogias1,2* , Jens Eyding2,3, Dirk Bartig1, Armin Grau4 and Ralph Weber2,5 Abstract Background: Comparing health care parameters of acute ischemic stroke (AIS) patients with and without concurrent coronavirus disease 2019 (Covid-19, SARS-CoV-2 infection), may be helpful in terms of optimizing clinical and public health care during pandemic. Methods: We evaluated a nationwide administrative database of all hospitalized patients with main diagnosis of acute ischemic stroke with/without diagnosis of Covid-19 who were hospitalized during the time period from January 16th to May 15th, 2020. Data from a total of 1463 hospitals in Germany were included. We compared case numbers, treatment characteristics (intravenous thrombolysis, IVT; mechanical thrombectomy, MT; treated on an intensive care unit, stroke unit or regular ward) and in-hospital mortality of AIS with and without concurrent diagnosis of Covid-19. Results: From a total of 30,864 hospitalized Covid-19 patients during the evaluation period in Germany, we identified a subgroup of 213 patients with primary diagnosis of AIS. Compared to the 68,700 AIS patients without Covid-19, this subgroup showed a similar rate of IVT (16.4% vs. 16.5%, p = 0.985) but a significantly lower rate of MT (3.8% vs. 7.9%, p = 0.017). In-hospital mortality rate was significantly higher in patients with AIS and concurrent Covid-19 compared to non-infected AIS patients (22.5% vs. 7.8%, p < 0.001). Conclusion: These nationwide data point out differences in mortality and medical treatment regime between AIS patients with and without concurrent Covid-19. Since the pandemic is still ongoing, these data draw attention to AIS as a less frequent but often fatal comorbidity in Covid-19 patients. Keywords: Covid-19, Stroke, Thrombolysis, Thrombectomy To the editor It is assumed that patients with Coronavirus disease 2019 (Covid-19, SARS-CoV-2 infection) and acute ischemic stroke (AIS) are treated and monitored differently, although these patients may have a higher risk of stroke compared to patients with other viral infections such as * Correspondence: [email protected] 1 Department of Neurology, St. Josef-Hospital Bochum, Ruhr University Bochum, Gudrunstr. 56, 44791 Bochum, Germany 2 Medical Faculty, Ruhr University of Bochum, Bochum, Germany Full list of author information is available at the end of the article
influenza [1]. To evaluate parameters of acute stroke care for Covid-19 patients with AIS, we analyzed nationwide treatment rates for Germany and in-hospital mortality in these patients for the time period January 16th to May 15th, 2020. Case numbers and treatment characteristics of all hospital admissions of AIS (ICD I63) with and without a concurrent diagnosis of Covid-19 (ICD U07.1) were analyzed using the high-quality and validated administra
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