Brain Bleeds Up in Patients With COVID-19 Treated for Ischemic Stroke

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Patients with acute ischemic stroke and COVID-19 also had worse clinical outcomes, including increased mortality

THURSDAY, Nov. 10, 2022 (HealthDay News) — Patients with acute ischemic stroke who also have COVID-19 have higher rates of intracranial bleeding complications and worse clinical outcomes following revascularization treatment than similar patients without COVID-19, according to a study published online Nov. 9 in Neurology.

João Pedro Marto, M.D., from Hospital de Egas Moniz in Lisbon, Portugal, and colleagues examined the safety and outcomes of revascularization treatments in patients with acute ischemic stroke and COVID-19 in a retrospective cohort study. Consecutive patients with acute ischemic stroke receiving intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) between March 2020 and June 2021, who were tested for severe acute respiratory syndrome coronavirus 2 infection, were included.

Data were included for 15,128 patients from 105 centers; 853 were diagnosed with COVID-19. The researchers found that 5,848 patients (38.7 percent) received IVT only and 9,280 patients (61.3 percent) received EVT, with or without IVT. The rates of symptomatic intracerebral hemorrhage (SICH), symptomatic subarachnoid hemorrhage (SSAH), SICH and/or SSAH, and 24-hour and three-month mortality were increased for patients with COVID-19 (adjusted odds ratios, 1.53, 1.80, 1.56, 2.47, and 1.88, respectively). At three months, COVID-19 patients also had an unfavorable shift in the distribution of the modified Rankin score (odds ratio, 1.42).

“While our study found a higher rate of brain bleeds in people with COVID-19, the number of people who experienced complications was still small,” Marto said in a statement. “We believe treatments to restore blood flow remain beneficial to people with ischemic stroke and COVID-19 and suggest they continue to be given as quickly as possible using current treatment recommendations.”

Several authors disclosed financial ties to the pharmaceutical and medical device industry.

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