Dataset Information

SARS-CoV-2 and Stroke Characteristics: A Report From the Multinational COVID-19 Stroke Study Group.

ABSTRACT: [Figure: see text].

SUBMITTER: Shahjouei S

PROVIDER: S-EPMC8078130 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

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Publications

SARS-CoV-2 and Stroke Characteristics: A Report From the Multinational COVID-19 Stroke Study Group.

Shahjouei Shima S Tsivgoulis Georgios G Farahmand Ghasem G Koza Eric E Mowla Ashkan A Vafaei Sadr Alireza A Kia Arash A Vaghefi Far Alaleh A Mondello Stefania S Cernigliaro Achille A Ranta Annemarei A Punter Martin M Khodadadi Faezeh F Naderi Soheil S Sabra Mirna M Ramezani Mahtab M Amini Harandi Ali A Olulana Oluwaseyi O Chaudhary Durgesh D Lyoubi Aicha A Campbell Bruce C V BCV Arenillas Juan F JF Bock Daniel D Montaner Joan J Aghayari Sheikh Neshin Saeideh S Aguiar de Sousa Diana D Tenser Matthew S MS Aires Ana A Alfonso Mercedes de Lera ML Alizada Orkhan O Azevedo Elsa E Goyal Nitin N Babaeepour Zabihollah Z Banihashemi Gelareh G Bonati Leo H LH Cereda Carlo W CW Chang Jason J JJ Crnjakovic Miljenko M De Marchis Gian Marco GM Del Sette Massimo M Ebrahimzadeh Seyed Amir SA Farhoudi Mehdi M Gandoglia Ilaria I Gonçalves Bruno B Griessenauer Christoph J CJ Murat Hanci Mehmet M Katsanos Aristeidis H AH Krogias Christos C Leker Ronen R RR Lotman Lev L Mai Jeffrey J Male Shailesh S Malhotra Konark K Malojcic Branko B Mesquita Teresa T Mir Ghasemi Asadollah A Mohamed Aref Hany H Mohseni Afshar Zeinab Z Moon Jusun J Niemelä Mika M Rezai Jahromi Behnam B Nolan Lawrence L Pandhi Abhi A Park Jong-Ho JH Marto João Pedro JP Purroy Francisco F Ranji-Burachaloo Sakineh S Carreira Nuno Reis NR Requena Manuel M Rubiera Marta M Sajedi Seyed Aidin SA Sargento-Freitas João J Sharma Vijay K VK Steiner Thorsten T Tempro Kristi K Turc Guillaume G Ahmadzadeh Yasaman Y Almasi-Dooghaee Mostafa M Assarzadegan Farhad F Babazadeh Arefeh A Baharvahdat Humain H Cardoso Fabricio Buchadid FB Dev Apoorva A Ghorbani Mohammad M Hamidi Ava A Hasheminejad Zeynab Sadat ZS Hojjat-Anasri Komachali Sahar S Khorvash Fariborz F Kobeissy Firas F Mirkarimi Hamidreza H Mohammadi-Vosough Elahe E Misra Debdipto D Noorian Ali Reza AR Nowrouzi-Sohrabi Peyman P Paybast Sepideh S Poorsaadat Leila L Roozbeh Mehrdad M Sabayan Behnam B Salehizadeh Saeideh S Saberi Alia A Sepehrnia Mercedeh M Vahabizad Fahimeh F Yasuda Thomas Alexandre TA Ghabaee Mojdeh M Rahimian Nasrin N Harirchian Mohammad Hossein MH Borhani-Haghighi Afshin A Azarpazhooh Mahmoud Reza MR Arora Rohan R Ansari Saeed S Avula Venkatesh V Li Jiang J Abedi Vida V Zand Ramin R

Stroke 20210421 5

[Figure: see text]. ...[more]

PMID: 33878892

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Project description:SARS-CoV-2 infected patients are suggested to have a higher incidence of thrombotic events such as acute ischemic strokes (AIS). This study aimed at exploring vascular comorbidity patterns among SARS-CoV-2 infected patients with subsequent stroke. We also investigated whether the comorbidities and their frequencies under each subclass of TOAST criteria were similar to the AIS population studies prior to the pandemic. This is a report from the Multinational COVID-19 Stroke Study Group. We present an original dataset of SASR-CoV-2 infected patients who had a subsequent stroke recorded through our multicenter prospective study. In addition, we built a dataset of previously reported patients by conducting a systematic literature review. We demonstrated distinct subgroups by clinical risk scoring models and unsupervised machine learning algorithms, including hierarchical K-Means (ML-K) and Spectral clustering (ML-S). This study included 323 AIS patients from 71 centers in 17 countries from the original dataset and 145 patients reported in the literature. The unsupervised clustering methods suggest a distinct cohort of patients (ML-K: 36% and ML-S: 42%) with no or few comorbidities. These patients were more than 6 years younger than other subgroups and more likely were men (ML-K: 59% and ML-S: 60%). The majority of patients in this subgroup suffered from an embolic-appearing stroke on imaging (ML-K: 83% and ML-S: 85%) and had about 50% risk of large vessel occlusions (ML-K: 50% and ML-S: 53%). In addition, there were two cohorts of patients with large-artery atherosclerosis (ML-K: 30% and ML-S: 43% of patients) and cardioembolic strokes (ML-K: 34% and ML-S: 15%) with consistent comorbidity and imaging patterns. Binominal logistic regression demonstrated that ischemic heart disease (odds ratio (OR), 4.9; 95% confidence interval (CI), 1.6-14.7), atrial fibrillation (OR, 14.0; 95% CI, 4.8-40.8), and active neoplasm (OR, 7.1; 95% CI, 1.4-36.2) were associated with cardioembolic stroke. Although a cohort of young and healthy men with cardioembolic and large vessel occlusions can be distinguished using both clinical sub-grouping and unsupervised clustering, stroke in other patients may be explained based on the existing comorbidities.

Project description:BackgroundThere is an increased attention to stroke following SARS-CoV-2. The goal of this study was to better depict the short-term risk of stroke and its associated factors among SARS-CoV-2 hospitalized patients.MethodsThis multicentre, multinational observational study includes hospitalized SARS-CoV-2 patients from North and South America (United States, Canada, and Brazil), Europe (Greece, Italy, Finland, and Turkey), Asia (Lebanon, Iran, and India), and Oceania (New Zealand). The outcome was the risk of subsequent stroke. Centres were included by non-probability sampling. The counts and clinical characteristics including laboratory findings and imaging of the patients with and without a subsequent stroke were recorded according to a predefined protocol. Quality, risk of bias, and heterogeneity assessments were conducted according to ROBINS-E and Cochrane Q-test. The risk of subsequent stroke was estimated through meta-analyses with random effect models. Bivariate logistic regression was used to determine the parameters with predictive outcome value. The study was reported according to the STROBE, MOOSE, and EQUATOR guidelines.FindingsWe received data from 26,175 hospitalized SARS-CoV-2 patients from 99 tertiary centres in 65 regions of 11 countries until May 1st, 2020. A total of 17,799 patients were included in meta-analyses. Among them, 156(0.9%) patients had a stroke-123(79%) ischaemic stroke, 27(17%) intracerebral/subarachnoid hemorrhage, and 6(4%) cerebral sinus thrombosis. Subsequent stroke risks calculated with meta-analyses, under low to moderate heterogeneity, were 0.5% among all centres in all countries, and 0.7% among countries with higher health expenditures. The need for mechanical ventilation (OR: 1.9, 95% CI:1.1-3.5, p = 0.03) and the presence of ischaemic heart disease (OR: 2.5, 95% CI:1.4-4.7, p = 0.006) were predictive of stroke.InterpretationThe results of this multi-national study on hospitalized patients with SARS-CoV-2 infection indicated an overall stroke risk of 0.5%(pooled risk: 0.9%). The need for mechanical ventilation and the history of ischaemic heart disease are the independent predictors of stroke among SARS-CoV-2 patients.FundingNone.

Dataset Information

SARS-CoV-2 and Stroke Characteristics: A Report From the Multinational COVID-19 Stroke Study Group.

Publications

SARS-CoV-2 and Stroke Characteristics: A Report From the Multinational COVID-19 Stroke Study Group.

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