• Pascal Jabbour, Adam A Dmytriw, Ahmad Sweid, Michel Piotin, Kimon Bekelis, Nader Sourour, Eytan Raz, Italo Linfante, Guilherme Dabus, Max Kole, Mario Martínez-Galdámez, Shahid M Nimjee, Demetrius K Lopes, Ameer E Hassan, Peter Kan, Mohammad Ghorbani, Michael R Levitt, Simon Escalard, Symeon Missios, Maksim Shapiro, Frédéric Clarençon, Mahmoud Elhorany, Daniel Vela-Duarte, Rizwan A Tahir, Patrick P Youssef, Aditya S Pandey, Robert M Starke, Kareem El Naamani, Rawad Abbas, Bassel Hammoud, Ossama Y Mansour, Jorge Galvan, Joshua T Billingsley, Abolghasem Mortazavi, Melanie Walker, Mahmoud Dibas, Fabio Settecase, HeranManraj K SMKSDivision of Neuroradiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, USA., Anna L Kuhn, Ajit S Puri, Bijoy K Menon, Sanjeev Sivakumar, Ashkan Mowla, Salvatore D'Amato, Alicia M Zha, Daniel Cooke, Mayank Goyal, Hannah Wu, Jake Cohen, David Turkel-Parrella, Andrew Xavier, Muhammad Waqas, Vincent M Tutino, Adnan Siddiqui, Gaurav Gupta, Anil Nanda, Priyank Khandelwal, Cristina Tiu, Pere C Portela, Natalia Perez de la Ossa, Xabier Urra, Mercedes de Lera, Juan F Arenillas, Marc Ribo, Manuel Requena, Mariangela Piano, Guglielmo Pero, Keith De Sousa, Fawaz Al-Mufti, Zafar Hashim, Sanjeev Nayak, Leonardo Renieri, Mohamed A Aziz-Sultan, Thanh N Nguyen, Patricia Feineigle, Aman B Patel, James E Siegler, Khodr Badih, Jonathan A Grossberg, Hassan Saad, M Reid Gooch, Nabeel A Herial, Robert H Rosenwasser, Stavropoula Tjoumakaris, and Ambooj Tiwari.
• Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
• Neurosurgery. 2022 Jun 1; 90 (6): 725733725-733.

BackgroundThe mechanisms and outcomes in coronavirus disease (COVID-19)-associated stroke are unique from those of non-COVID-19 stroke.ObjectiveTo describe the efficacy and outcomes of acute revascularization of large vessel occlusion (LVO) in the setting of COVID-19 in an international cohort.MethodsWe conducted an international multicenter retrospective study of consecutively admitted patients with COVID-19 with concomitant acute LVO across 50 comprehensive stroke centers. Our control group constituted historical controls of patients presenting with LVO and receiving a mechanical thrombectomy between January 2018 and December 2020.ResultsThe total cohort was 575 patients with acute LVO; 194 patients had COVID-19 while 381 patients did not. Patients in the COVID-19 group were younger (62.5 vs 71.2; P < .001) and lacked vascular risk factors (49, 25.3% vs 54, 14.2%; P = .001). Modified thrombolysis in cerebral infarction 3 revascularization was less common in the COVID-19 group (74, 39.2% vs 252, 67.2%; P < .001). Poor functional outcome at discharge (defined as modified Ranklin Scale 3-6) was more common in the COVID-19 group (150, 79.8% vs 132, 66.7%; P = .004). COVID-19 was independently associated with a lower likelihood of achieving modified thrombolysis in cerebral infarction 3 (odds ratio [OR]: 0.4, 95% CI: 0.2-0.7; P < .001) and unfavorable outcomes (OR: 2.5, 95% CI: 1.4-4.5; P = .002).ConclusionCOVID-19 was an independent predictor of incomplete revascularization and poor outcomes in patients with stroke due to LVO. Patients with COVID-19 with LVO were younger, had fewer cerebrovascular risk factors, and suffered from higher morbidity/mortality rates.Copyright © Congress of Neurological Surgeons 2022. All rights reserved.

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