New data from the Global COVID-19 Stroke Registry suggest higher rates of intracranial bleeding complications and worse outcomes of stroke revascularization in acute ischemic stroke complicated by COVID-19. MedTwitter
However, study investigator João Pedro Marto, MD, with Hospital de Egas Moniz, Lisbon, Portugal, cautioned that the number of patients who experienced complications was small.
AIS is a recognized complication of SARS-CoV-2 infection, believed to be due to virus-related inflammation, endothelial dysfunction and coagulopathy. To investigate, Marto and colleagues looked back at 15,128 patients with AIS . A total of 853 patients were diagnosed with COVID-19 and the remainder were COVID-negative controls.
In"doubly robust adjusted outcome analysis on multiple imputed datasets," patients with COVID-19 had a higher rate of symptomatic ICH , symptomatic SAH , and both combined , the researchers report.In the treatment subgroup analysis, both IVT-only and EVT patients had an increased risk for ICH, while only EVT patients showed an increased risk for symptomatic SAH.
They were more than twice as likely to die within 24 hours of stroke treatment and 88% more likely to die 3 months after treatment . Importantly, they note, the"relatively large margin of benefit of revascularization treatments, in particular of EVT, and the rather small absolute numbers of symptomatic hemorrhage in patients with AIS and COVID-19 make it likely that revascularization treatments remain beneficial for these patients."