PT  - JOURNAL ARTICLE
AU  - Dmytriw, Adam A
AU  - Dibas, Mahmoud
AU  - Phan, Kevin
AU  - Efendizade, Aslan
AU  - Ospel, Johanna
AU  - Schirmer, Clemens
AU  - Settecase, Fabio
AU  - Heran, Manraj K S
AU  - Kühn, Anna Luisa
AU  - Puri, Ajit S
AU  - Menon, Bijoy K
AU  - Sivakumar, Sanjeev
AU  - Mowla, Askan
AU  - Vela-Duarte, Daniel
AU  - Linfante, Italo
AU  - Dabus, Guilherme C
AU  - Regenhardt, Robert W
AU  - D'Amato, Salvatore
AU  - Rosenthal, Joseph A
AU  - Zha, Alicia
AU  - Talukder, Nafee
AU  - Sheth, Sunil A
AU  - Hassan, Ameer E
AU  - Cooke, Daniel L
AU  - Leung, Lester Y
AU  - Malek, Adel M
AU  - Voetsch, Barbara
AU  - Sehgal, Siddharth
AU  - Wakhloo, Ajay K
AU  - Goyal, Mayank
AU  - Wu, Hannah
AU  - Cohen, Jake
AU  - Ghozy, Sherief
AU  - Turkel-Parella, David
AU  - Farooq, Zerwa
AU  - Vranic, Justin E
AU  - Rabinov, James D
AU  - Stapleton, Christopher J
AU  - Minhas, Ramandeep
AU  - Velayudhan, Vinodkumar
AU  - Chaudhry, Zeshan Ahmed
AU  - Xavier, Andrew
AU  - Bullrich, Maria Bres
AU  - Pandey, Sachin
AU  - Sposato, Luciano A
AU  - Johnson, Stephen A
AU  - Gupta, Gaurav
AU  - Khandelwal, Priyank
AU  - Ali, Latisha
AU  - Liebeskind, David S
AU  - Farooqui, Mudassir
AU  - Ortega-Gutierrez, Santiago
AU  - Nahab, Fadi
AU  - Jillella, Dinesh V
AU  - Chen, Karen
AU  - Aziz-Sultan, Mohammad Ali
AU  - Abdalkader, Mohamad
AU  - Kaliaev, Artem
AU  - Nguyen, Thanh N
AU  - Haussen, Diogo C
AU  - Nogueira, Raul G
AU  - Haq, Israr Ul
AU  - Zaidat, Osama O
AU  - Sanborn, Emma
AU  - Leslie-Mazwi, Thabele M
AU  - Patel, Aman B
AU  - Siegler, James E
AU  - Tiwari, Ambooj
ED  - ,
TI  - Acute ischaemic stroke associated with SARS-CoV-2 infection in North America
AID  - 10.1136/jnnp-2021-328354
DP  - 2022 Apr 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - 360--368
VI  - 93
IP  - 4
4099  - http://jnnp.bmj.com/content/93/4/360.short
4100  - http://jnnp.bmj.com/content/93/4/360.full
SO  - J Neurol Neurosurg Psychiatry2022 Apr 01; 93
AB  - Background To analyse the clinical characteristics of COVID-19 with acute ischaemic stroke (AIS) and identify factors predicting functional outcome.Methods Multicentre retrospective cohort study of COVID-19 patients with AIS who presented to 30 stroke centres in the USA and Canada between 14 March and 30 August 2020. The primary endpoint was poor functional outcome, defined as a modified Rankin Scale (mRS) of 5 or 6 at discharge. Secondary endpoints include favourable outcome (mRS ≤2) and mortality at discharge, ordinal mRS (shift analysis), symptomatic intracranial haemorrhage (sICH) and occurrence of in-hospital complications.Results A total of 216 COVID-19 patients with AIS were included. 68.1% (147/216) were older than 60 years, while 31.9% (69/216) were younger. Median [IQR] National Institutes of Health Stroke Scale (NIHSS) at presentation was 12.5 (15.8), and 44.2% (87/197) presented with large vessel occlusion (LVO). Approximately 51.3% (98/191) of the patients had poor outcomes with an observed mortality rate of 39.1% (81/207). Age >60 years (aOR: 5.11, 95% CI 2.08 to 12.56, p<0.001), diabetes mellitus (aOR: 2.66, 95% CI 1.16 to 6.09, p=0.021), higher NIHSS at admission (aOR: 1.08, 95% CI 1.02 to 1.14, p=0.006), LVO (aOR: 2.45, 95% CI 1.04 to 5.78, p=0.042), and higher NLR level (aOR: 1.06, 95% CI 1.01 to 1.11, p=0.028) were significantly associated with poor functional outcome.Conclusion There is relationship between COVID-19-associated AIS and severe disability or death. We identified several factors which predict worse outcomes, and these outcomes were more frequent compared to global averages. We found that elevated neutrophil-to-lymphocyte ratio, rather than D-Dimer, predicted both morbidity and mortality.Data are available on reasonable request.