| Title: |
Increased risk of acute stroke among patients with severe COVID-19: a multicenter study and meta-analysis |
| Authors: |
Siepmann, T; Sedghi, A; Simon, E; Winzer, S; Barlinn, J; de With, K; Mirow, L; Wolz, M; Gruenewald, T; Schroettner, P; von Bonin, S; Pallesen, L-P; Rosengarten, B; Schubert, J; Lohmann, T; Machetanz, J; Spieth, P; Koch, T; Bornstein, S; Reichmann, H; Puetz, V; Barlinn, K |
| Source: |
Siepmann, T; Sedghi, A; Simon, E; Winzer, S; Barlinn, J; de With, K; Mirow, L; Wolz, M; Gruenewald, T; Schroettner, P; von Bonin, S; Pallesen, L-P; Rosengarten, B; Schubert, J; Lohmann, T; Machetanz, J; Spieth, P; Koch, T; Bornstein, S; Reichmann, H; Puetz, V; Barlinn, K (2021). Increased risk of acute stroke among patients with severe COVID-19: a multicenter study and meta-analysis. European Journal of Neurology, 28(1):238-247. |
| Publisher Information: |
Wiley-Blackwell Publishing, Inc. |
| Publication Year: |
2021 |
| Collection: |
University of Zurich (UZH): ZORA (Zurich Open Repository and Archive |
| Subject Terms: |
Clinic for Endocrinology and Diabetology; 610 Medicine & health |
| Description: |
BACKGROUND AND PURPOSE Recent observations linked coronavirus disease 2019 (COVID-19) to thromboembolic complications possibly mediated by increased blood coagulability and inflammatory endothelial impairment. We aimed to define the risk of acute stroke in patients with severe and non-severe COVID-19. METHODS We performed an observational, multicenter cohort study in four participating hospitals in Saxony, Germany to characterize consecutive patients with laboratory-confirmed COVID-19 who experienced acute stroke during hospitalization. Furthermore, we conducted a systematic review using PubMed/MEDLINE, Embase, Cochrane Library and bibliographies of identified papers following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines including data from observational studies of acute stroke in COVID-19 patients. Data were extracted by two independent reviewers and pooled with multicenter data to calculate risk ratios (RRs) and 95% confidence intervals (95% CIs) for acute stroke related to COVID-19 severity using a random-effects model. Between-study heterogeneity was assessed using Cochran's Q and I$^{2}$ statistics. International Prospective Register of Systematic Reviews registration number: CRD42020187194. RESULTS Of 165 patients hospitalized for COVID-19 (49.1% males, median age = 67 years [57-79 years], 72.1% severe or critical) included in the multicenter study, overall stroke rate was 4.2% (95% CI: 1.9-8.7). Systematic literature search identified two observational studies involving 576 patients that were eligible for meta-analysis. Amongst 741 pooled COVID-19 patients, overall stroke rate was 2.9% (95% CI: 1.9-4.5). Risk of acute stroke was increased for patients with severe compared to non-severe COVID-19 (RR = 4.18, 95% CI: 1.7-10.25; P = 0.002) with no evidence of heterogeneity (I$^{2}$ = 0%, P = 0.82). CONCLUSIONS Synthesized analysis of data from our multicenter study and previously published cohorts indicates that severity of COVID-19 is associated with an increased risk of ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| ISSN: |
1351-5101 |
| Relation: |
https://www.zora.uzh.ch/id/eprint/200102/1/document11.03.02.pdf; info:pmid/32920964; urn:issn:1351-5101 |
| DOI: |
10.1111/ene.14535 |
| Availability: |
https://www.zora.uzh.ch/id/eprint/200102/; https://www.zora.uzh.ch/id/eprint/200102/1/document11.03.02.pdf; https://doi.org/10.1111/ene.14535 |
| Rights: |
info:eu-repo/semantics/openAccess ; Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ; http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| Accession Number: |
edsbas.9381CDA1 |
| Database: |
BASE |