Open Access
Risk of stroke in hospitalized SARS-CoV-2 infected patients: A multinational study
Shima Shahjouei
1
,
Soheil Naderi
2, 3
,
Jiang Li
4
,
Ayesha Khan
1
,
Durgesh Chaudhary
1
,
Ghasem Farahmand
5
,
Shailesh S. Male
6
,
Christoph J. Griessenauer
1
,
Mirna Sabra
7
,
Stefania Mondello
8
,
Achille Cernigliaro
9
,
Faezeh Khodadadi
10
,
Apoorva Dev
10
,
Nitin Goyal
11
,
Sakineh Ranji-Burachaloo
5
,
Oluwaseyi Olulana
1
,
Venkatesh Avula
1
,
Seyed Amir Ebrahimzadeh
12
,
Orkhan Alizada
13
,
Murat Hanci
13
,
Askar Ghorbani
5
,
Alaleh Vaghefi Far
14
,
A. Ranta
14, 15
,
Martin Punter
14, 15
,
Mahtab Ramezani
16
,
Nima Ostadrahimi
3
,
Georgios Tsivgoulis
11, 17
,
Paraskevi Fragkou
18
,
Peyman Nowrouzi-Sohrabi
19
,
Emmanouil Karofylakis
18
,
Sotirios Tsiodras
18
,
Saeideh Neshin Aghayari Sheikh
20
,
Alia Saberi
20
,
Mika Niemelä
21
,
Behnam Rezai Jahromi
21
,
A. Mowla
22
,
Mahsa Mashayekhi
23
,
Reza Bavarsad Shahripour
11
,
Seyed Aidin Sajedi
24
,
Mohammad Ghorbani
25
,
Arash Kia
26
,
Nasrin Rahimian
27
,
Vida Abedi
28, 29
,
R. Zand
2, 11
1
Neurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA.
|
2
Neurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA
|
4
Department of Molecular and Functional Genomics, Geisinger Health System, Danville, PA, USA.
|
6
Neurology Department, Vidant Medical Center, Greenville, NC, USA
|
9
Regional Health Authority of Sicily, Palermo, Italy
|
12
Radiology Department, Yasrebi Hospital, Kashan, Iran
|
14
Department of Neurology, Wellington Hospital, Wellington, New Zealand
|
20
27
Neurology Department, Yasrebi Hospital, Kashan, Iran
|
29
Department of Molecular and Functional Genomics, Geisinger Health System, Danville, PA, USA
|
Publication type: Journal Article
Publication date: 2020-09-01
scimago Q1
wos Q1
SJR: 3.591
CiteScore: 17.1
Impact factor: 10.8
ISSN: 23523964
PubMed ID:
32818804
General Biochemistry, Genetics and Molecular Biology
General Medicine
Abstract
Abstract
Background
There is an increased attention to stroke following SARS-CoV-2. The goal of this study was to better depict the short-term risk of stroke and its associated factors among SARS-CoV-2 hospitalized patients.Methods
This multicentre, multinational observational study includes hospitalized SARS-CoV-2 patients from North and South America (United States, Canada, and Brazil), Europe (Greece, Italy, Finland, and Turkey), Asia (Lebanon, Iran, and India), and Oceania (New Zealand). The outcome was the risk of subsequent stroke. Centres were included by non-probability sampling. The counts and clinical characteristics including laboratory findings and imaging of the patients with and without a subsequent stroke were recorded according to a predefined protocol. Quality, risk of bias, and heterogeneity assessments were conducted according to ROBINS-E and Cochrane Q-test. The risk of subsequent stroke was estimated through meta-analyses with random effect models. Bivariate logistic regression was used to determine the parameters with predictive outcome value. The study was reported according to the STROBE, MOOSE, and EQUATOR guidelines.Findings
We received data from 26,175 hospitalized SARS-CoV-2 patients from 99 tertiary centres in 65 regions of 11 countries until May 1st, 2020. A total of 17,799 patients were included in meta-analyses. Among them, 156(0.9%) patients had a stroke—123(79%) ischaemic stroke, 27(17%) intracerebral/subarachnoid hemorrhage, and 6(4%) cerebral sinus thrombosis. Subsequent stroke risks calculated with meta-analyses, under low to moderate heterogeneity, were 0.5% among all centres in all countries, and 0.7% among countries with higher health expenditures. The need for mechanical ventilation (OR: 1.9, 95% CI:1.1–3.5, p = 0.03) and the presence of ischaemic heart disease (OR: 2.5, 95% CI:1.4–4.7, p = 0.006) were predictive of stroke.Interpretation
The results of this multi-national study on hospitalized patients with SARS-CoV-2 infection indicated an overall stroke risk of 0.5%(pooled risk: 0.9%). The need for mechanical ventilation and the history of ischaemic heart disease are the independent predictors of stroke among SARS-CoV-2 patients.Funding
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Total citations:
83
Citations from 2024:
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(10.84%)
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GOST
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Shahjouei S. et al. Risk of stroke in hospitalized SARS-CoV-2 infected patients: A multinational study // EBioMedicine. 2020. Vol. 59. p. 102939.
GOST all authors (up to 50)
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Shahjouei S., Naderi S., Li J., Khan A., Chaudhary D., Farahmand G., Male S. S., Griessenauer C. J., Sabra M., Mondello S., Cernigliaro A., Khodadadi F., Dev A., Goyal N., Ranji-Burachaloo S., Olulana O., Avula V., Ebrahimzadeh S. A., Alizada O., Hanci M., Ghorbani A., Vaghefi Far A., Ranta A., Punter M., Ramezani M., Ostadrahimi N., Tsivgoulis G., Fragkou P., Nowrouzi-Sohrabi P., Karofylakis E., Tsiodras S., Neshin Aghayari Sheikh S., Saberi A., Niemelä M., Rezai Jahromi B., Mowla A., Mashayekhi M., Bavarsad Shahripour R., Sajedi S. A., Ghorbani M., Kia A., Rahimian N., Abedi V., Zand R. Risk of stroke in hospitalized SARS-CoV-2 infected patients: A multinational study // EBioMedicine. 2020. Vol. 59. p. 102939.
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TY - JOUR
DO - 10.1016/j.ebiom.2020.102939
UR - https://doi.org/10.1016/j.ebiom.2020.102939
TI - Risk of stroke in hospitalized SARS-CoV-2 infected patients: A multinational study
T2 - EBioMedicine
AU - Shahjouei, Shima
AU - Naderi, Soheil
AU - Li, Jiang
AU - Khan, Ayesha
AU - Chaudhary, Durgesh
AU - Farahmand, Ghasem
AU - Male, Shailesh S.
AU - Griessenauer, Christoph J.
AU - Sabra, Mirna
AU - Mondello, Stefania
AU - Cernigliaro, Achille
AU - Khodadadi, Faezeh
AU - Dev, Apoorva
AU - Goyal, Nitin
AU - Ranji-Burachaloo, Sakineh
AU - Olulana, Oluwaseyi
AU - Avula, Venkatesh
AU - Ebrahimzadeh, Seyed Amir
AU - Alizada, Orkhan
AU - Hanci, Murat
AU - Ghorbani, Askar
AU - Vaghefi Far, Alaleh
AU - Ranta, A.
AU - Punter, Martin
AU - Ramezani, Mahtab
AU - Ostadrahimi, Nima
AU - Tsivgoulis, Georgios
AU - Fragkou, Paraskevi
AU - Nowrouzi-Sohrabi, Peyman
AU - Karofylakis, Emmanouil
AU - Tsiodras, Sotirios
AU - Neshin Aghayari Sheikh, Saeideh
AU - Saberi, Alia
AU - Niemelä, Mika
AU - Rezai Jahromi, Behnam
AU - Mowla, A.
AU - Mashayekhi, Mahsa
AU - Bavarsad Shahripour, Reza
AU - Sajedi, Seyed Aidin
AU - Ghorbani, Mohammad
AU - Kia, Arash
AU - Rahimian, Nasrin
AU - Abedi, Vida
AU - Zand, R.
PY - 2020
DA - 2020/09/01
PB - Elsevier
SP - 102939
VL - 59
PMID - 32818804
SN - 2352-3964
ER -
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@article{2020_Shahjouei,
author = {Shima Shahjouei and Soheil Naderi and Jiang Li and Ayesha Khan and Durgesh Chaudhary and Ghasem Farahmand and Shailesh S. Male and Christoph J. Griessenauer and Mirna Sabra and Stefania Mondello and Achille Cernigliaro and Faezeh Khodadadi and Apoorva Dev and Nitin Goyal and Sakineh Ranji-Burachaloo and Oluwaseyi Olulana and Venkatesh Avula and Seyed Amir Ebrahimzadeh and Orkhan Alizada and Murat Hanci and Askar Ghorbani and Alaleh Vaghefi Far and A. Ranta and Martin Punter and Mahtab Ramezani and Nima Ostadrahimi and Georgios Tsivgoulis and Paraskevi Fragkou and Peyman Nowrouzi-Sohrabi and Emmanouil Karofylakis and Sotirios Tsiodras and Saeideh Neshin Aghayari Sheikh and Alia Saberi and Mika Niemelä and Behnam Rezai Jahromi and A. Mowla and Mahsa Mashayekhi and Reza Bavarsad Shahripour and Seyed Aidin Sajedi and Mohammad Ghorbani and Arash Kia and Nasrin Rahimian and Vida Abedi and R. Zand},
title = {Risk of stroke in hospitalized SARS-CoV-2 infected patients: A multinational study},
journal = {EBioMedicine},
year = {2020},
volume = {59},
publisher = {Elsevier},
month = {sep},
url = {https://doi.org/10.1016/j.ebiom.2020.102939},
pages = {102939},
doi = {10.1016/j.ebiom.2020.102939}
}