TY - JOUR T1 - Acute ischaemic stroke associated with SARS-CoV-2 infection in North America JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 360 LP - 368 DO - 10.1136/jnnp-2021-328354 VL - 93 IS - 4 AU - Adam A Dmytriw AU - Mahmoud Dibas AU - Kevin Phan AU - Aslan Efendizade AU - Johanna Ospel AU - Clemens Schirmer AU - Fabio Settecase AU - Manraj K S Heran AU - Anna Luisa Kühn AU - Ajit S Puri AU - Bijoy K Menon AU - Sanjeev Sivakumar AU - Askan Mowla AU - Daniel Vela-Duarte AU - Italo Linfante AU - Guilherme C Dabus AU - Robert W Regenhardt AU - Salvatore D'Amato AU - Joseph A Rosenthal AU - Alicia Zha AU - Nafee Talukder AU - Sunil A Sheth AU - Ameer E Hassan AU - Daniel L Cooke AU - Lester Y Leung AU - Adel M Malek AU - Barbara Voetsch AU - Siddharth Sehgal AU - Ajay K Wakhloo AU - Mayank Goyal AU - Hannah Wu AU - Jake Cohen AU - Sherief Ghozy AU - David Turkel-Parella AU - Zerwa Farooq AU - Justin E Vranic AU - James D Rabinov AU - Christopher J Stapleton AU - Ramandeep Minhas AU - Vinodkumar Velayudhan AU - Zeshan Ahmed Chaudhry AU - Andrew Xavier AU - Maria Bres Bullrich AU - Sachin Pandey AU - Luciano A Sposato AU - Stephen A Johnson AU - Gaurav Gupta AU - Priyank Khandelwal AU - Latisha Ali AU - David S Liebeskind AU - Mudassir Farooqui AU - Santiago Ortega-Gutierrez AU - Fadi Nahab AU - Dinesh V Jillella AU - Karen Chen AU - Mohammad Ali Aziz-Sultan AU - Mohamad Abdalkader AU - Artem Kaliaev AU - Thanh N Nguyen AU - Diogo C Haussen AU - Raul G Nogueira AU - Israr Ul Haq AU - Osama O Zaidat AU - Emma Sanborn AU - Thabele M Leslie-Mazwi AU - Aman B Patel AU - James E Siegler AU - Ambooj Tiwari A2 - , Y1 - 2022/04/01 UR - http://jnnp.bmj.com/content/93/4/360.abstract N2 - 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. ER -