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Ischaemic stroke associated with COVID-19 and racial outcome disparity in North America
  1. Adam A Dmytriw1,2,
  2. Kevin Phan2,
  3. Clemens Schirmer3,
  4. Fabio Settecase4,
  5. Manraj K S Heran4,
  6. Aslan Efendizade5,
  7. Anna Luisa Kühn6,
  8. Ajit S Puri6,
  9. Bijoy K Menon7,
  10. Mahmoud Dibas2,
  11. Sanjeev Sivakumar8,
  12. Askan Mowla9,
  13. Lester Y Leung10,
  14. Adel M Malek11,
  15. Barbara Voetsch12,
  16. Siddharth Sehgal12,
  17. Ajay K Wakhloo13,
  18. Hannah Wu2,14,15,
  19. Andrew Xavier16,17,
  20. Ambooj Tiwari2,14,15
  1. 1 Neuroradiology & Neurointervention Service, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
  2. 2 Interventional Neuro Associates, Greenvale, NY 11548, USA
  3. 3 Department of Neurosurgery & Neuroscience Institute, Geisinger, Wilkes-Barre, Pennsylvania, USA
  4. 4 Division of Interventional Neuroradiology, Vancouver General Hospital, Vancouver, BC, Canada
  5. 5 Department of Radiology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
  6. 6 Department of Neurointerventional Radiology, UMass Memorial Hospital, Worcester, MA, United States
  7. 7 Calgary Stroke Program, Cumming School of Medicine, Calgary, AB, Canada
  8. 8 Department of Medicine (Neurology), Prisma Health Upstate, USC, Greenville, SC, United States
  9. 9 Department of Neurological Surgery, University of Southern California, Los Angeles, CA, United States
  10. 10 Department of Neurology, Tufts Medical Center, Boston, MA, United States
  11. 11 Departments of Neurosurgery, Tufts Medical Center, Boston, MA, United States
  12. 12 Department of Neurology, Lahey Hospital & Medical Center, Burlington, MA, United States
  13. 13 Neurointerventional Radiology, Lahey Hospital & Medical Center, Burlington, MA, United States
  14. 14 Department of Neurology, Brookdale University Hospital, Brooklyn, NY, United States
  15. 15 Department of Neurology, Jamaica Medical Center, Richmond Hill, NY, United States
  16. 16 Department of Neurology, Sinai Grace Hospital, Detroit, MI, United States
  17. 17 Department of Neurology, St. Joseph Mercy Health, Ann Arbor, MI, United States
  1. Correspondence to Dr Adam A Dmytriw, Neuroradiology & Neurointervention Service, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA; admytriw{at}bwh.harvard.edu

https://doi.org/10.1136/jnnp-2020-324653

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    A retrospective study from the COVID-19 outbreak in Wuhan, China demonstrated an incidence of acute ischaemic stroke of approximately 5% in hospitalised patients with severe disease.1 However, there has been limited evidence on the influence of racial background in stroke outcomes in this pandemic. We report 69 cases of acute stroke in patients positive for SARS-CoV-2, including 27 of African–American background and 42 of other racial backgrounds, including Caucasian, Hispanic and Asian. All patients presented to 14 major hospitals in the USA and Canada, from 14 March 2020 to 14 April 2020. The study was maintained under IRB #s20-00765.

    All patients had nasopharyngeal swab samples that were positive for SARS-CoV-2 on qualitative reverse-transcriptase-PCR assays. In the following, we present a dichotomised analysis of ischaemic stroke outcomes between patients of African–American background as reported on hospital intake questionnaire versus patients of all other backgrounds. All variables stratified to race (African–American vs others). For continuous variables, when the data are normal, t-test was used and data were presented in the form of mean (SD). If they were not normally distributed, the Wilcoxon rank-sum test was used and the …

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    Footnotes

    • Twitter @AdamDmytriw, @amboojtiwari

    • Contributors AAD, AX and AT conceived and designed the research. AAD, KP, CS, FS, MKSH, AE, ALK, ASP, BKM, MD, SS1, AM, LYL, AMM, BV, SS2, AKW, HW, AX and AT collected and reviewed the data. AAD, KP, and MD analysed the data and performed the statistical analysis. AX and AT handled the funding and supervision of the research. AAD and AT drafted the manuscript. AAD, KP, CS, FS, MKSH, AE, ALK, ASP, BKM, MD, SS1, AM, LYL, AMM, BV, SS2, AKW, HW, AX and AT revised the manuscript and reviewed the final version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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