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Neurology:COVID-19患者的卒中风险、临床表型和死亡情况分析

2020-09-16 MedSci原创 MedSci原创

COVID-19患者发生卒中相对频繁,并且各个年龄段患者都有严重的结局。老年人、合并症和COVID-19呼吸系统症状严重程度之间的相互作用与患者极高的死亡率相关。

近日,神经病学领域权威杂志Neurology上发表了一篇研究文章,该研究旨在调查COVID-19患者发生卒中具有独特特征的假说,并调查了该人群的卒中风险、临床表型和预后。

研究人员进行了系统的检索,得到了10项报告COVID-19患者卒中频率的研究,并与一个加拿大尚未发表的研究进行汇总。研究人员采用随机效应荟萃分析来估计COVID-19患者中发生脑卒中的比例。研究人员对COVID-19患者(n=125)中的卒中病例进行了系统的检索,并将这些数据与来自加拿大、美国和伊朗的35例未发表的病例进行汇总。研究人员按患者年龄段(<50、50-70,>70岁)进行分组,并分析了患者临床特征和住院死亡率。研究人员应用聚类分析来确定特定的临床表型及其与死亡之间的关系。

研究发现发生卒中(1.8%,95%CI为0.9-3.7%)和院内死亡(34.4%,95%CI为27.2-42.4%)的COVID-19患者比例非常高。<50岁的患者的死亡率比>70岁的患者低67%(OR为0.33,95%CI为0.12-0.94,P=0.039)。大血管阻塞的发生率是既往报道的两倍(46.9%),并且在所有年龄组中都很高,即使没有危险因素或合并症也是如此。临床表型的特点是年龄较大、合并症负担增加以及严重的COVID-19呼吸道症状与最高的院内死亡率(58.6%)相关,并且死亡风险比其他人群高出3倍(OR为3.52,95%CI为1.53-8.09,P=0.003)。

由此可见,COVID-19患者发生卒中相对频繁,并且各个年龄段患者都有严重的结局。老年人、合并症和COVID-19呼吸系统症状严重程度之间的相互作用与患者极高的死亡率相关。

原始出处:

Sebastian Fridman.et al.Stroke Risk, phenotypes, and death in COVID-19: Systematic review and newly reported cases.Neurology.2020.https://doi.org/10.1212/WNL.0000000000010851

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    2020-09-18 tastas
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    2020-09-17 Jessica

    老年人、合并症和COVID-19呼吸系统症状严重程度之间的相互作用与患者极高的死亡率相关。

    0

  7. 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authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Wed Sep 16 20:52:31 CST 2020, time=2020-09-16, status=1, ipAttribution=)]
    2020-09-17 新手区新手

    这个很新

    0

  8. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Wed Sep 16 22:16:47 CST 2020, time=2020-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045979, encodeId=60bb10459e926, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Wed Sep 16 22:16:47 CST 2020, time=2020-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=885873, encodeId=7fb08858e3ac, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Wed Sep 16 20:52:31 CST 2020, time=2020-09-16, status=1, ipAttribution=)]
    2020-09-16 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2001114, encodeId=ea942001114da, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Fri Mar 12 20:16:47 CST 2021, time=2021-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281346, encodeId=83e2128134681, content=<a href='/topic/show?id=455f36085f0' target=_blank style='color:#2F92EE;'>#卒中风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36085, encryptionId=455f36085f0, topicName=卒中风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f1167, 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211019/df01a4bfb64246379ddfef3370d04115/e1274c8eb5e440918f56f83bcfea9031.jpg, createdBy=3a345397082, createdName=Jessica, createdTime=Thu Sep 17 17:34:37 CST 2020, time=2020-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=886104, encodeId=8dbc886104d4, content=这个很新, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200811/34935bf531b24fcc9ad97977f261b84d/258bb5c512754458868fca3f28f1061b.jpg, createdBy=ef545410182, createdName=新手区新手, createdTime=Thu Sep 17 16:56:56 CST 2020, time=2020-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026692, encodeId=b84a1026692f7, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Wed Sep 16 22:16:47 CST 2020, time=2020-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045979, encodeId=60bb10459e926, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Wed Sep 16 22:16:47 CST 2020, time=2020-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=885873, encodeId=7fb08858e3ac, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Wed Sep 16 20:52:31 CST 2020, time=2020-09-16, status=1, ipAttribution=)]
    2020-09-16 guging

    中风是俗称,应该称为缺血性卒中吧

    0

  10. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211019/df01a4bfb64246379ddfef3370d04115/e1274c8eb5e440918f56f83bcfea9031.jpg, createdBy=3a345397082, createdName=Jessica, createdTime=Thu Sep 17 17:34:37 CST 2020, time=2020-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=886104, encodeId=8dbc886104d4, content=这个很新, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200811/34935bf531b24fcc9ad97977f261b84d/258bb5c512754458868fca3f28f1061b.jpg, createdBy=ef545410182, createdName=新手区新手, createdTime=Thu Sep 17 16:56:56 CST 2020, time=2020-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026692, encodeId=b84a1026692f7, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Wed Sep 16 22:16:47 CST 2020, time=2020-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045979, encodeId=60bb10459e926, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Wed Sep 16 22:16:47 CST 2020, time=2020-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=885873, encodeId=7fb08858e3ac, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Wed Sep 16 20:52:31 CST 2020, time=2020-09-16, status=1, ipAttribution=)]
    2020-09-16 wxl882001

    了解

    0

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