In Hospital Mortality and Short-Term Outcomes of Acute Ischemic Stroke Patients Contracting SARS CoV-2 Infection: Experience from a Dedicated Stroke Unit in Bangladesh

ATM Hasibul Hasan, Subir Chandra Das, Muhammad Sougatul Islam, Mohaimen Mansur, Nushrat Khan, Mohammad Shah Jahirul Hoque Chowdhury
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Abstract

Background: The influence of COVID-19 on in hospital mortality and short-term outcome of acute ischemic stroke is not well known. Objective: The purpose of the present study was to analyze the overall impact of COVID-19 patients and 30-day outcomes of acute ischemic stroke patients. Methodology: This was a hospital-based case-control study from February to May 2021 conducted in stroke unit of National Institute of Neurosciences and Hospital. Consecutive ischemic stroke patients contracting COVID-19 infection was considered as case group and similar patients, negative for SARS CoV-2 on RT-PCR from nasal swab were considered for control group following the inclusion and exclusion criteria. Results: A total number of 50 cases and 99 similar control were taken. Although a significant proportion of control group were male (76.8% vs 50%), there was similar age distribution in both groups. Diabetes and Multiple comorbid conditions and lymphopenia were significantly (p value of <0.001) more common among the case (1% versus 22%, 28.3% versus 56% and 5.1% versus 54%) in contrast to hypertension and lymphocytosis which was more frequent in control group (42.4% versus 10% and 94.9% versus 46%). Though the cases had a significantly (p value <0.001) higher NIHSS score at admission (median IQR 7 versus 13) and longer hospital stay (median IQR 6 days versus 14 days). Male stroke patients were 4.7 times more likely to die in-hospital compared to female patients. The risk of mortality were 5 times higher among cases. Conclusion: COVID positive stroke cases have more severe disease at admission and longer hospital stays and the risk of mortality is 5 times higher in COVID positive stroke cases with a significant male dominance. Journal of National Institute of Neurosciences Bangladesh, January 2023;9(1):11-15
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急性缺血性中风患者感染SARS - CoV-2的住院死亡率和短期预后:来自孟加拉国专门中风部门的经验
背景:COVID-19对急性缺血性脑卒中住院死亡率和短期预后的影响尚不清楚。目的:本研究的目的是分析COVID-19患者和急性缺血性脑卒中患者30天预后的总体影响。方法:这是一项基于医院的病例对照研究,于2021年2月至5月在国家神经科学与医院研究所卒中单元进行。连续缺血性卒中患者感染COVID-19为病例组,鼻拭子RT-PCR阴性的类似患者为对照组,符合纳入和排除标准。结果:共50例,对照组99例。虽然对照组男性占比显著(76.8% vs 50%),但两组患者的年龄分布相似。与高血压和淋巴细胞增多症相比,糖尿病和多重合并症和淋巴细胞减少症在该病例中更为常见(p值为<0.001)(1%对22%,28.3%对56%,5.1%对54%),而高血压和淋巴细胞增多症在对照组中更为常见(42.4%对10%,94.9%对46%)。虽然这些病例入院时的NIHSS评分明显(p值<0.001)较高(IQR中位数为7比13),住院时间较长(IQR中位数为6天比14天)。男性中风患者在医院死亡的可能性是女性患者的4.7倍。病例中死亡风险高出5倍。结论:COVID阳性脑卒中患者入院时病情更严重,住院时间更长,死亡风险高5倍,且男性优势明显。孟加拉国国家神经科学研究所杂志,2023年1月;9(1):11-15
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