European Multicenter Study of ET-COVID-19

Federico Cagnazzo; Michel Piotin; Simon Escalard; Benjamin Maier; Marc Ribo; Manuel Requena; Raoul Pop; Anca Hasiu; Roberto Gasparotti; Dikran Mardighian; Mariangela Piano; Amedeo Cervo; Omer Faruk Eker; Vincent Durous; Nader-Antoine Sourour; Mahmoud Elhorany; Andrea Zini; Luigi Simonetti; Simona Marcheselli; Nuzzi Nunzio Paolo; Emmanuel Houdart; Alexis Guédon; Noémie Ligot; Benjamin Mine; Arturo Consoli; Bertrand Lapergue; Pere Cordona Portela; Xabier Urra; Alejandro Rodriguez; Federico Bolognini; Pablo Ariel Lebedinsky; Anne Pasco-Papon; Sophie Godard; Gaultier Marnat; Igor Sibon; Nicola Limbucci; Patrizia Nencini; Sergio Nappini; Valentina Saia; Valentina Caldiera; Daniele Romano; Giulia Frauenfelder; Ivan Gallesio; Giuliano Gola; Roberto Menozzi; Antonio Genovese; Alberto Terrana; Andrea Giorgianni; Manuel Cappellari; Raffaele Augelli; Paolo Invernizzi; Marco Pavia; Elvis Lafe; Anna Cavallini; Alessia Giossi; Michele Besana; Luca Valvassori; Antonio Macera; Lucio Castellan; Giancarlo Salsano; Fortunato Di Caterino; Alessandra Biondi; Caroline Arquizan; Julien Lebreuche; Gianluca Galvano; Alfio Cannella; Mirco Cosottini; Guido Lazzarotti; Giuseppe Guizzardi; Alessandro Stecco; Rossana Tassi; Sandra Bracco; Elena Bianchini; Camilla Micieli; Rosario Pascarella; Manuela Napoli; Francesco Causin; Hubert Desal; François Cotton; Vincent Costalat; François Delvoye; Gabriele Ciccio; Stanislas Smajda; Hocine Redjem; Solène Hébert; Raphaël Blanc; Mikael Mazighi; Jean-Philippes Desilles; Dan Mihoc; Monica Manisor; Rémy Beaujeux; Véronique Quenardelle; Roxana Gheoca; Valérie Wolff; Guiglielmo Pero; Giussani Giuditta; Ceresa Chiara; Roberto Riva; Matteo Cappucci; Morgane Laubacher; Celia Tuttle; Lorenzo Piergallini; Francis Turjman; Frédéric Clarençon; Eimad Shotar; Stéphanie Lenck; Kevin Premat; Vincent Degos; Yves Samson; Charlotte Rosso; Sonia Alamowitch; Luigi Cirillo; Mauro Gentile; Ludovica Migliaccio; Salvatore Isceri; Simone Rossi; Tommaso Baldini; Massimo Dall’Olio; Martino Cellerini; Jean-Pierre Saint-Maurice; Vittorio Civelli; Matteo Fantoni; Naeije Gilles; Jodaïtis Lise; Lubicz Boris; Stephanie Elens; Bonnet Thomas; Guenego Adrien; Sadeghi Niloufar; Van Nuffelen Marc; Federico Di Maria; Oguzhan Coskun; Georges Rodesch; Sergio Zimatore; Gariel Florent; Jérôme Berge; Patrice Menegon; Xavier Barreau; Thomas Tourdias; Stéphane Olindo; Ludovic Lucas; Jean-Sebastien Liegey; Sharmila Sagnier; Pauline Renou; Marie Couture; Sabrina Debruxelles; Mathilde Poli; Mariano Musacchio; Mariette Delaitre; Riccardo Padolecchia; Giuseppe Ganci; Annalisa Sugo; Barbero Stefano; Taverna Giacomo Giovanni; Umberto Scoditti; Paola Castellini; Lilia Latte; Ilaria Grisendi; Enrico Epifani; Francesco Vizzari; Stefano Molinaro; Luca Nativo; Gabriele Vinacci; Bruno Bonetti; Nicola Micheletti; Giampaolo Tomelleri; Piergiuseppe Zampieri; Mauro Plebani; Andrea Grazioli; Giuseppe Kenneth Ricciardi; Alessandra Polistena; Sgreccia Alessando; Giuseppina Sanfilippo; Alessandra Persico; William Boadu; Maria Giovanna Cuzzoni; Serena Magno; Gianpaolo Toscano; Maria Federica Denaro; Piera Tosi; Bruno Censori; Valentina Puglisi; Luisa Vinciguerra; Valeria De Giuli; Nicola Mavillo; Leonardo Renieri; Enrico Fainardi; Giovanni Vitale; Primikiris Panagiotis; Guillaume Charbonnier; Moratti Claudio; Fabrizio Sallustio; Andrea Wlderk; Riccardo Russo; Mauro Bergui; Chiara Comelli; Andrea Boghi; Marinette Moynier; Elisa Francesca Maria Ciceri; Danilo Toni; Julien Frandon; Isabelle Mourand; Nicolas Gaillard; Salvatore Mangiafico; Imad Derraz; Cyril Dargazanli; Pierre-Henri Lefevre; Carlos Riquelme; Gregory Gascou; Alain Bonafe

doi:10.1161/STROKEAHA.120.031514

European Multicenter Study of ET-COVID-19

Federico Cagnazzo, Michel Piotin, Simon Escalard, Benjamin Maier, Marc Ribo, Manuel Requena, Raoul Pop, Anca Hasiu, Roberto Gasparotti, Dikran Mardighian, Mariangela Piano, Amedeo Cervo, Omer Faruk Eker, Vincent Durous, Nader-Antoine Sourour, Mahmoud Elhorany, Andrea Zini, Luigi Simonetti, Simona Marcheselli, Nuzzi Nunzio PaoloEmmanuel Houdart, Alexis Guédon, Noémie Ligot, Benjamin Mine, Arturo Consoli, Bertrand Lapergue, Pere Cordona Portela, Xabier Urra, Alejandro Rodriguez, Federico Bolognini, Pablo Ariel Lebedinsky, Anne Pasco-Papon, Sophie Godard, Gaultier Marnat, Igor Sibon, Nicola Limbucci, Patrizia Nencini, Sergio Nappini, Valentina Saia, Valentina Caldiera, Daniele Romano, Giulia Frauenfelder, Ivan Gallesio, Giuliano Gola, Roberto Menozzi, Antonio Genovese, Alberto Terrana, Andrea Giorgianni, Manuel Cappellari, Raffaele Augelli, Paolo Invernizzi, Marco Pavia, Elvis Lafe, Anna Cavallini, Alessia Giossi, Michele Besana, Luca Valvassori, Antonio Macera, Lucio Castellan, Giancarlo Salsano, Fortunato Di Caterino, Alessandra Biondi, Caroline Arquizan, Julien Lebreuche, Gianluca Galvano, Alfio Cannella, Mirco Cosottini, Guido Lazzarotti, Giuseppe Guizzardi, Alessandro Stecco, Rossana Tassi, Sandra Bracco, Elena Bianchini, Camilla Micieli, Rosario Pascarella, Manuela Napoli, Francesco Causin, Hubert Desal, François Cotton, Vincent Costalat, François Delvoye, Gabriele Ciccio, Stanislas Smajda, Hocine Redjem, Solène Hébert, Raphaël Blanc, Mikael Mazighi, Jean-Philippes Desilles, Dan Mihoc, Monica Manisor, Rémy Beaujeux, Véronique Quenardelle, Roxana Gheoca, Valérie Wolff, Guiglielmo Pero, Giussani Giuditta, Ceresa Chiara, Roberto Riva, Matteo Cappucci, Morgane Laubacher, Celia Tuttle, Lorenzo Piergallini, Francis Turjman, Frédéric Clarençon, Eimad Shotar, Stéphanie Lenck, Kevin Premat, Vincent Degos, Yves Samson, Charlotte Rosso, Sonia Alamowitch, Luigi Cirillo, Mauro Gentile, Ludovica Migliaccio, Salvatore Isceri, Simone Rossi, Tommaso Baldini, Massimo Dall’Olio, Martino Cellerini, Jean-Pierre Saint-Maurice, Vittorio Civelli, Matteo Fantoni, Naeije Gilles, Jodaïtis Lise, Lubicz Boris, Stephanie Elens, Bonnet Thomas, Guenego Adrien, Sadeghi Niloufar, Van Nuffelen Marc, Federico Di Maria, Oguzhan Coskun, Georges Rodesch, Sergio Zimatore, Gariel Florent, Jérôme Berge, Patrice Menegon, Xavier Barreau, Thomas Tourdias, Stéphane Olindo, Ludovic Lucas, Jean-Sebastien Liegey, Sharmila Sagnier, Pauline Renou, Marie Couture, Sabrina Debruxelles, Mathilde Poli, Mariano Musacchio, Mariette Delaitre, Riccardo Padolecchia, Giuseppe Ganci, Annalisa Sugo, Barbero Stefano, Taverna Giacomo Giovanni, Umberto Scoditti, Paola Castellini, Lilia Latte, Ilaria Grisendi, Enrico Epifani, Francesco Vizzari, Stefano Molinaro, Luca Nativo, Gabriele Vinacci, Bruno Bonetti, Nicola Micheletti, Giampaolo Tomelleri, Piergiuseppe Zampieri, Mauro Plebani, Andrea Grazioli, Giuseppe Kenneth Ricciardi, Alessandra Polistena, Sgreccia Alessando, Giuseppina Sanfilippo, Alessandra Persico, William Boadu, Maria Giovanna Cuzzoni, Serena Magno, Gianpaolo Toscano, Maria Federica Denaro, Piera Tosi, Bruno Censori, Valentina Puglisi, Luisa Vinciguerra, Valeria De Giuli, Nicola Mavillo, Leonardo Renieri, Enrico Fainardi, Giovanni Vitale, Primikiris Panagiotis, Guillaume Charbonnier, Moratti Claudio, Fabrizio Sallustio, Andrea Wlderk, Riccardo Russo, Mauro Bergui, Chiara Comelli, Andrea Boghi, Marinette Moynier, Elisa Francesca Maria Ciceri, Danilo Toni, Julien Frandon, Isabelle Mourand, Nicolas Gaillard, Salvatore Mangiafico, Imad Derraz, Cyril Dargazanli, Pierre-Henri Lefevre, Carlos Riquelme, Gregory Gascou, Alain Bonafe

Research output: Contribution to journal › Article › peer-review

Abstract

Background and Purpose: Acute ischemic stroke and large vessel occlusion can be concurrent with the coronavirus disease 2019 (COVID-19) infection. Outcomes after mechanical thrombectomy (MT) for large vessel occlusion in patients with COVID-19 are substantially unknown. Our aim was to study early outcomes after MT in patients with COVID-19. Methods: Multicenter, European, cohort study involving 34 stroke centers in France, Italy, Spain, and Belgium. Data were collected between March 1, 2020 and May 5, 2020. Consecutive laboratory-confirmed COVID-19 cases with large vessel occlusion, who were treated with MT, were included. Primary investigated outcome: 30-day mortality. Secondary outcomes: early neurological improvement (National Institutes of Health Stroke Scale improvement ≥8 points or 24 hours National Institutes of Health Stroke Scale 0–1), successful reperfusion (modified Thrombolysis in Cerebral Infarction grade ≥2b), and symptomatic intracranial hemorrhage. Results: We evaluated 93 patients with COVID-19 with large vessel occlusion who underwent MT (median age, 71 years [interquartile range, 59–79]; 63 men [67.7%]). Median pretreatment National Institutes of Health Stroke Scale and Alberta Stroke Program Early CT Score were 17 (interquartile range, 11–21) and 8 (interquartile range, 7–9), respectively. Anterior circulation acute ischemic stroke represented 93.5% of cases. The rate modified Thrombolysis in Cerebral Infarction 2b to 3 was 79.6% (74 patients [95% CI, 71.3–87.8]). Thirty-day mortality was 29% (27 patients [95% CI, 20–39.4]). Early neurological improvement was 19.5% (17 patients [95% CI, 11.8–29.5]), and symptomatic intracranial hemorrhage was 5.4% (5 patients [95% CI, 1.7–12.1]). Patients who died at 30 days exhibited significantly lower lymphocyte count, higher levels of aspartate, and LDH (lactate dehydrogenase). After adjustment for age, initial National Institutes of Health Stroke Scale, Alberta Stroke Program Early CT Score, and successful reperfusion, these biological markers remained associated with increased odds of 30-day mortality (adjusted odds ratio of 2.70 [95% CI, 1.21–5.98] per SD-log decrease in lymphocyte count, 2.66 [95% CI, 1.22–5.77] per SD-log increase in aspartate, and 4.30 [95% CI, 1.43–12.91] per SD-log increase in LDH). Conclusions: The 29% rate of 30-day mortality after MT among patients with COVID-19 is not negligible. Abnormalities of lymphocyte count, LDH and aspartate may depict a patient’s profiles with poorer outcomes after MT. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT04406090.

Original language	English
Pages (from-to)	31-39
Number of pages	9
Journal	Stroke
Volume	52
Issue number	1
DOIs	https://doi.org/10.1161/STROKEAHA.120.031514
Publication status	Published - 2021

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10.1161/STROKEAHA.120.031514

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Cagnazzo, F., Piotin, M., Escalard, S., Maier, B., Ribo, M., Requena, M., Pop, R., Hasiu, A., Gasparotti, R., Mardighian, D., Piano, M., Cervo, A., Eker, O. F., Durous, V., Sourour, N-A., Elhorany, M., Zini, A., Simonetti, L., Marcheselli, S., ... Bonafe, A. (2021). European Multicenter Study of ET-COVID-19. Stroke, 52(1), 31-39. https://doi.org/10.1161/STROKEAHA.120.031514

Cagnazzo, F, Piotin, M, Escalard, S, Maier, B, Ribo, M, Requena, M, Pop, R, Hasiu, A, Gasparotti, R, Mardighian, D, Piano, M, Cervo, A, Eker, OF, Durous, V, Sourour, N-A, Elhorany, M, Zini, A, Simonetti, L, Marcheselli, S, Paolo, NN, Houdart, E, Guédon, A, Ligot, N, Mine, B, Consoli, A, Lapergue, B, Cordona Portela, P, Urra, X, Rodriguez, A, Bolognini, F, Lebedinsky, PA, Pasco-Papon, A, Godard, S, Marnat, G, Sibon, I, Limbucci, N, Nencini, P, Nappini, S, Saia, V, Caldiera, V, Romano, D, Frauenfelder, G, Gallesio, I, Gola, G, Menozzi, R, Genovese, A, Terrana, A, Giorgianni, A, Cappellari, M, Augelli, R, Invernizzi, P, Pavia, M, Lafe, E, Cavallini, A, Giossi, A, Besana, M, Valvassori, L, Macera, A, Castellan, L , Salsano, G, Di Caterino, F, Biondi, A, Arquizan, C, Lebreuche, J, Galvano, G, Cannella, A, Cosottini, M, Lazzarotti, G, Guizzardi, G, Stecco, A, Tassi, R, Bracco, S, Bianchini, E, Micieli, C, Pascarella, R, Napoli, M, Causin, F, Desal, H, Cotton, F, Costalat, V, Delvoye, F, Ciccio, G, Smajda, S, Redjem, H, Hébert, S, Blanc, R, Mazighi, M, Desilles, J-P, Mihoc, D, Manisor, M, Beaujeux, R, Quenardelle, V, Gheoca, R, Wolff, V, Pero, G, Giuditta, G, Chiara, C, Riva, R, Cappucci, M, Laubacher, M, Tuttle, C, Piergallini, L, Turjman, F, Clarençon, F, Shotar, E, Lenck, S, Premat, K, Degos, V, Samson, Y, Rosso, C, Alamowitch, S, Cirillo, L, Gentile, M, Migliaccio, L, Isceri, S, Rossi, S, Baldini, T, Dall’Olio, M, Cellerini, M, Saint-Maurice, J-P, Civelli, V, Fantoni, M, Gilles, N, Lise, J, Boris, L, Elens, S, Thomas, B, Adrien, G, Niloufar, S, Marc, VN, Maria, FD, Coskun, O, Rodesch, G, Zimatore, S, Florent, G, Berge, J, Menegon, P, Barreau, X, Tourdias, T, Olindo, S, Lucas, L, Liegey, J-S, Sagnier, S, Renou, P, Couture, M, Debruxelles, S, Poli, M, Musacchio, M, Delaitre, M, Padolecchia, R, Ganci, G, Sugo, A, Stefano, B, Giovanni, TG, Scoditti, U, Castellini, P, Latte, L, Grisendi, I, Epifani, E, Vizzari, F, Molinaro, S, Nativo, L, Vinacci, G, Bonetti, B, Micheletti, N, Tomelleri, G, Zampieri, P, Plebani, M, Grazioli, A, Ricciardi, GK, Polistena, A, Alessando, S, Sanfilippo, G, Persico, A, Boadu, W, Cuzzoni, MG, Magno, S, Toscano, G , Denaro, MF , Tosi, P, Censori, B, Puglisi, V, Vinciguerra, L, De Giuli, V, Mavillo, N, Renieri, L, Fainardi, E, Vitale, G, Panagiotis, P, Charbonnier, G, Claudio, M, Sallustio, F, Wlderk, A, Russo, R, Bergui, M, Comelli, C, Boghi, A, Moynier, M, Maria Ciceri, EF, Toni, D, Frandon, J, Mourand, I, Gaillard, N, Mangiafico, S, Derraz, I, Dargazanli, C, Lefevre, P-H, Riquelme, C, Gascou, G & Bonafe, A 2021, 'European Multicenter Study of ET-COVID-19', Stroke, vol. 52, no. 1, pp. 31-39. https://doi.org/10.1161/STROKEAHA.120.031514

@article{cbbeb61819374d6aac82d8642d269455,

title = "European Multicenter Study of ET-COVID-19",

abstract = "Background and Purpose: Acute ischemic stroke and large vessel occlusion can be concurrent with the coronavirus disease 2019 (COVID-19) infection. Outcomes after mechanical thrombectomy (MT) for large vessel occlusion in patients with COVID-19 are substantially unknown. Our aim was to study early outcomes after MT in patients with COVID-19. Methods: Multicenter, European, cohort study involving 34 stroke centers in France, Italy, Spain, and Belgium. Data were collected between March 1, 2020 and May 5, 2020. Consecutive laboratory-confirmed COVID-19 cases with large vessel occlusion, who were treated with MT, were included. Primary investigated outcome: 30-day mortality. Secondary outcomes: early neurological improvement (National Institutes of Health Stroke Scale improvement ≥8 points or 24 hours National Institutes of Health Stroke Scale 0–1), successful reperfusion (modified Thrombolysis in Cerebral Infarction grade ≥2b), and symptomatic intracranial hemorrhage. Results: We evaluated 93 patients with COVID-19 with large vessel occlusion who underwent MT (median age, 71 years [interquartile range, 59–79]; 63 men [67.7%]). Median pretreatment National Institutes of Health Stroke Scale and Alberta Stroke Program Early CT Score were 17 (interquartile range, 11–21) and 8 (interquartile range, 7–9), respectively. Anterior circulation acute ischemic stroke represented 93.5% of cases. The rate modified Thrombolysis in Cerebral Infarction 2b to 3 was 79.6% (74 patients [95% CI, 71.3–87.8]). Thirty-day mortality was 29% (27 patients [95% CI, 20–39.4]). Early neurological improvement was 19.5% (17 patients [95% CI, 11.8–29.5]), and symptomatic intracranial hemorrhage was 5.4% (5 patients [95% CI, 1.7–12.1]). Patients who died at 30 days exhibited significantly lower lymphocyte count, higher levels of aspartate, and LDH (lactate dehydrogenase). After adjustment for age, initial National Institutes of Health Stroke Scale, Alberta Stroke Program Early CT Score, and successful reperfusion, these biological markers remained associated with increased odds of 30-day mortality (adjusted odds ratio of 2.70 [95% CI, 1.21–5.98] per SD-log decrease in lymphocyte count, 2.66 [95% CI, 1.22–5.77] per SD-log increase in aspartate, and 4.30 [95% CI, 1.43–12.91] per SD-log increase in LDH). Conclusions: The 29% rate of 30-day mortality after MT among patients with COVID-19 is not negligible. Abnormalities of lymphocyte count, LDH and aspartate may depict a patient{\textquoteright}s profiles with poorer outcomes after MT. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT04406090.",

author = "Federico Cagnazzo and Michel Piotin and Simon Escalard and Benjamin Maier and Marc Ribo and Manuel Requena and Raoul Pop and Anca Hasiu and Roberto Gasparotti and Dikran Mardighian and Mariangela Piano and Amedeo Cervo and Eker, {Omer Faruk} and Vincent Durous and Nader-Antoine Sourour and Mahmoud Elhorany and Andrea Zini and Luigi Simonetti and Simona Marcheselli and Paolo, {Nuzzi Nunzio} and Emmanuel Houdart and Alexis Gu{\'e}don and No{\'e}mie Ligot and Benjamin Mine and Arturo Consoli and Bertrand Lapergue and {Cordona Portela}, Pere and Xabier Urra and Alejandro Rodriguez and Federico Bolognini and Lebedinsky, {Pablo Ariel} and Anne Pasco-Papon and Sophie Godard and Gaultier Marnat and Igor Sibon and Nicola Limbucci and Patrizia Nencini and Sergio Nappini and Valentina Saia and Valentina Caldiera and Daniele Romano and Giulia Frauenfelder and Ivan Gallesio and Giuliano Gola and Roberto Menozzi and Antonio Genovese and Alberto Terrana and Andrea Giorgianni and Manuel Cappellari and Raffaele Augelli and Paolo Invernizzi and Marco Pavia and Elvis Lafe and Anna Cavallini and Alessia Giossi and Michele Besana and Luca Valvassori and Antonio Macera and Lucio Castellan and Giancarlo Salsano and {Di Caterino}, Fortunato and Alessandra Biondi and Caroline Arquizan and Julien Lebreuche and Gianluca Galvano and Alfio Cannella and Mirco Cosottini and Guido Lazzarotti and Giuseppe Guizzardi and Alessandro Stecco and Rossana Tassi and Sandra Bracco and Elena Bianchini and Camilla Micieli and Rosario Pascarella and Manuela Napoli and Francesco Causin and Hubert Desal and Fran{\c c}ois Cotton and Vincent Costalat and Fran{\c c}ois Delvoye and Gabriele Ciccio and Stanislas Smajda and Hocine Redjem and Sol{\`e}ne H{\'e}bert and Rapha{\"e}l Blanc and Mikael Mazighi and Jean-Philippes Desilles and Dan Mihoc and Monica Manisor and R{\'e}my Beaujeux and V{\'e}ronique Quenardelle and Roxana Gheoca and Val{\'e}rie Wolff and Guiglielmo Pero and Giussani Giuditta and Ceresa Chiara and Roberto Riva and Matteo Cappucci and Morgane Laubacher and Celia Tuttle and Lorenzo Piergallini and Francis Turjman and Fr{\'e}d{\'e}ric Claren{\c c}on and Eimad Shotar and St{\'e}phanie Lenck and Kevin Premat and Vincent Degos and Yves Samson and Charlotte Rosso and Sonia Alamowitch and Luigi Cirillo and Mauro Gentile and Ludovica Migliaccio and Salvatore Isceri and Simone Rossi and Tommaso Baldini and Massimo Dall{\textquoteright}Olio and Martino Cellerini and Jean-Pierre Saint-Maurice and Vittorio Civelli and Matteo Fantoni and Naeije Gilles and Joda{\"i}tis Lise and Lubicz Boris and Stephanie Elens and Bonnet Thomas and Guenego Adrien and Sadeghi Niloufar and Marc, {Van Nuffelen} and Maria, {Federico Di} and Oguzhan Coskun and Georges Rodesch and Sergio Zimatore and Gariel Florent and J{\'e}r{\^o}me Berge and Patrice Menegon and Xavier Barreau and Thomas Tourdias and St{\'e}phane Olindo and Ludovic Lucas and Jean-Sebastien Liegey and Sharmila Sagnier and Pauline Renou and Marie Couture and Sabrina Debruxelles and Mathilde Poli and Mariano Musacchio and Mariette Delaitre and Riccardo Padolecchia and Giuseppe Ganci and Annalisa Sugo and Barbero Stefano and Giovanni, {Taverna Giacomo} and Umberto Scoditti and Paola Castellini and Lilia Latte and Ilaria Grisendi and Enrico Epifani and Francesco Vizzari and Stefano Molinaro and Luca Nativo and Gabriele Vinacci and Bruno Bonetti and Nicola Micheletti and Giampaolo Tomelleri and Piergiuseppe Zampieri and Mauro Plebani and Andrea Grazioli and Ricciardi, {Giuseppe Kenneth} and Alessandra Polistena and Sgreccia Alessando and Giuseppina Sanfilippo and Alessandra Persico and William Boadu and Cuzzoni, {Maria Giovanna} and Serena Magno and Gianpaolo Toscano and Denaro, {Maria Federica} and Piera Tosi and Bruno Censori and Valentina Puglisi and Luisa Vinciguerra and {De Giuli}, Valeria and Nicola Mavillo and Leonardo Renieri and Enrico Fainardi and Giovanni Vitale and Primikiris Panagiotis and Guillaume Charbonnier and Moratti Claudio and Fabrizio Sallustio and Andrea Wlderk and Riccardo Russo and Mauro Bergui and Chiara Comelli and Andrea Boghi and Marinette Moynier and {Maria Ciceri}, {Elisa Francesca} and Danilo Toni and Julien Frandon and Isabelle Mourand and Nicolas Gaillard and Salvatore Mangiafico and Imad Derraz and Cyril Dargazanli and Pierre-Henri Lefevre and Carlos Riquelme and Gregory Gascou and Alain Bonafe",

year = "2021",

doi = "10.1161/STROKEAHA.120.031514",

language = "English",

volume = "52",

pages = "31--39",

journal = "Stroke",

issn = "0039-2499",

number = "1",

}

TY - JOUR

T1 - European Multicenter Study of ET-COVID-19

AU - Cagnazzo, Federico

AU - Piotin, Michel

AU - Escalard, Simon

AU - Maier, Benjamin

AU - Ribo, Marc

AU - Requena, Manuel

AU - Pop, Raoul

AU - Hasiu, Anca

AU - Gasparotti, Roberto

AU - Mardighian, Dikran

AU - Piano, Mariangela

AU - Cervo, Amedeo

AU - Eker, Omer Faruk

AU - Durous, Vincent

AU - Sourour, Nader-Antoine

AU - Elhorany, Mahmoud

AU - Zini, Andrea

AU - Simonetti, Luigi

AU - Marcheselli, Simona

AU - Paolo, Nuzzi Nunzio

AU - Houdart, Emmanuel

AU - Guédon, Alexis

AU - Ligot, Noémie

AU - Mine, Benjamin

AU - Consoli, Arturo

AU - Lapergue, Bertrand

AU - Cordona Portela, Pere

AU - Urra, Xabier

AU - Rodriguez, Alejandro

AU - Bolognini, Federico

AU - Lebedinsky, Pablo Ariel

AU - Pasco-Papon, Anne

AU - Godard, Sophie

AU - Marnat, Gaultier

AU - Sibon, Igor

AU - Limbucci, Nicola

AU - Nencini, Patrizia

AU - Nappini, Sergio

AU - Saia, Valentina

AU - Caldiera, Valentina

AU - Romano, Daniele

AU - Frauenfelder, Giulia

AU - Gallesio, Ivan

AU - Gola, Giuliano

AU - Menozzi, Roberto

AU - Genovese, Antonio

AU - Terrana, Alberto

AU - Giorgianni, Andrea

AU - Cappellari, Manuel

AU - Augelli, Raffaele

AU - Invernizzi, Paolo

AU - Pavia, Marco

AU - Lafe, Elvis

AU - Cavallini, Anna

AU - Giossi, Alessia

AU - Besana, Michele

AU - Valvassori, Luca

AU - Macera, Antonio

AU - Castellan, Lucio

AU - Salsano, Giancarlo

AU - Di Caterino, Fortunato

AU - Biondi, Alessandra

AU - Arquizan, Caroline

AU - Lebreuche, Julien

AU - Galvano, Gianluca

AU - Cannella, Alfio

AU - Cosottini, Mirco

AU - Lazzarotti, Guido

AU - Guizzardi, Giuseppe

AU - Stecco, Alessandro

AU - Tassi, Rossana

AU - Bracco, Sandra

AU - Bianchini, Elena

AU - Micieli, Camilla

AU - Pascarella, Rosario

AU - Napoli, Manuela

AU - Causin, Francesco

AU - Desal, Hubert

AU - Cotton, François

AU - Costalat, Vincent

AU - Delvoye, François

AU - Ciccio, Gabriele

AU - Smajda, Stanislas

AU - Redjem, Hocine

AU - Hébert, Solène

AU - Blanc, Raphaël

AU - Mazighi, Mikael

AU - Desilles, Jean-Philippes

AU - Mihoc, Dan

AU - Manisor, Monica

AU - Beaujeux, Rémy

AU - Quenardelle, Véronique

AU - Gheoca, Roxana

AU - Wolff, Valérie

AU - Pero, Guiglielmo

AU - Giuditta, Giussani

AU - Chiara, Ceresa

AU - Riva, Roberto

AU - Cappucci, Matteo

AU - Laubacher, Morgane

AU - Tuttle, Celia

AU - Piergallini, Lorenzo

AU - Turjman, Francis

AU - Clarençon, Frédéric

AU - Shotar, Eimad

AU - Lenck, Stéphanie

AU - Premat, Kevin

AU - Degos, Vincent

AU - Samson, Yves

AU - Rosso, Charlotte

AU - Alamowitch, Sonia

AU - Cirillo, Luigi

AU - Gentile, Mauro

AU - Migliaccio, Ludovica

AU - Isceri, Salvatore

AU - Rossi, Simone

AU - Baldini, Tommaso

AU - Dall’Olio, Massimo

AU - Cellerini, Martino

AU - Saint-Maurice, Jean-Pierre

AU - Civelli, Vittorio

AU - Fantoni, Matteo

AU - Gilles, Naeije

AU - Lise, Jodaïtis

AU - Boris, Lubicz

AU - Elens, Stephanie

AU - Thomas, Bonnet

AU - Adrien, Guenego

AU - Niloufar, Sadeghi

AU - Marc, Van Nuffelen

AU - Maria, Federico Di

AU - Coskun, Oguzhan

AU - Rodesch, Georges

AU - Zimatore, Sergio

AU - Florent, Gariel

AU - Berge, Jérôme

AU - Menegon, Patrice

AU - Barreau, Xavier

AU - Tourdias, Thomas

AU - Olindo, Stéphane

AU - Lucas, Ludovic

AU - Liegey, Jean-Sebastien

AU - Sagnier, Sharmila

AU - Renou, Pauline

AU - Couture, Marie

AU - Debruxelles, Sabrina

AU - Poli, Mathilde

AU - Musacchio, Mariano

AU - Delaitre, Mariette

AU - Padolecchia, Riccardo

AU - Ganci, Giuseppe

AU - Sugo, Annalisa

AU - Stefano, Barbero

AU - Giovanni, Taverna Giacomo

AU - Scoditti, Umberto

AU - Castellini, Paola

AU - Latte, Lilia

AU - Grisendi, Ilaria

AU - Epifani, Enrico

AU - Vizzari, Francesco

AU - Molinaro, Stefano

AU - Nativo, Luca

AU - Vinacci, Gabriele

AU - Bonetti, Bruno

AU - Micheletti, Nicola

AU - Tomelleri, Giampaolo

AU - Zampieri, Piergiuseppe

AU - Plebani, Mauro

AU - Grazioli, Andrea

AU - Ricciardi, Giuseppe Kenneth

AU - Polistena, Alessandra

AU - Alessando, Sgreccia

AU - Sanfilippo, Giuseppina

AU - Persico, Alessandra

AU - Boadu, William

AU - Cuzzoni, Maria Giovanna

AU - Magno, Serena

AU - Toscano, Gianpaolo

AU - Denaro, Maria Federica

AU - Tosi, Piera

AU - Censori, Bruno

AU - Puglisi, Valentina

AU - Vinciguerra, Luisa

AU - De Giuli, Valeria

AU - Mavillo, Nicola

AU - Renieri, Leonardo

AU - Fainardi, Enrico

AU - Vitale, Giovanni

AU - Panagiotis, Primikiris

AU - Charbonnier, Guillaume

AU - Claudio, Moratti

AU - Sallustio, Fabrizio

AU - Wlderk, Andrea

AU - Russo, Riccardo

AU - Bergui, Mauro

AU - Comelli, Chiara

AU - Boghi, Andrea

AU - Moynier, Marinette

AU - Maria Ciceri, Elisa Francesca

AU - Toni, Danilo

AU - Frandon, Julien

AU - Mourand, Isabelle

AU - Gaillard, Nicolas

AU - Mangiafico, Salvatore

AU - Derraz, Imad

AU - Dargazanli, Cyril

AU - Lefevre, Pierre-Henri

AU - Riquelme, Carlos

AU - Gascou, Gregory

AU - Bonafe, Alain

PY - 2021

Y1 - 2021

N2 - Background and Purpose: Acute ischemic stroke and large vessel occlusion can be concurrent with the coronavirus disease 2019 (COVID-19) infection. Outcomes after mechanical thrombectomy (MT) for large vessel occlusion in patients with COVID-19 are substantially unknown. Our aim was to study early outcomes after MT in patients with COVID-19. Methods: Multicenter, European, cohort study involving 34 stroke centers in France, Italy, Spain, and Belgium. Data were collected between March 1, 2020 and May 5, 2020. Consecutive laboratory-confirmed COVID-19 cases with large vessel occlusion, who were treated with MT, were included. Primary investigated outcome: 30-day mortality. Secondary outcomes: early neurological improvement (National Institutes of Health Stroke Scale improvement ≥8 points or 24 hours National Institutes of Health Stroke Scale 0–1), successful reperfusion (modified Thrombolysis in Cerebral Infarction grade ≥2b), and symptomatic intracranial hemorrhage. Results: We evaluated 93 patients with COVID-19 with large vessel occlusion who underwent MT (median age, 71 years [interquartile range, 59–79]; 63 men [67.7%]). Median pretreatment National Institutes of Health Stroke Scale and Alberta Stroke Program Early CT Score were 17 (interquartile range, 11–21) and 8 (interquartile range, 7–9), respectively. Anterior circulation acute ischemic stroke represented 93.5% of cases. The rate modified Thrombolysis in Cerebral Infarction 2b to 3 was 79.6% (74 patients [95% CI, 71.3–87.8]). Thirty-day mortality was 29% (27 patients [95% CI, 20–39.4]). Early neurological improvement was 19.5% (17 patients [95% CI, 11.8–29.5]), and symptomatic intracranial hemorrhage was 5.4% (5 patients [95% CI, 1.7–12.1]). Patients who died at 30 days exhibited significantly lower lymphocyte count, higher levels of aspartate, and LDH (lactate dehydrogenase). After adjustment for age, initial National Institutes of Health Stroke Scale, Alberta Stroke Program Early CT Score, and successful reperfusion, these biological markers remained associated with increased odds of 30-day mortality (adjusted odds ratio of 2.70 [95% CI, 1.21–5.98] per SD-log decrease in lymphocyte count, 2.66 [95% CI, 1.22–5.77] per SD-log increase in aspartate, and 4.30 [95% CI, 1.43–12.91] per SD-log increase in LDH). Conclusions: The 29% rate of 30-day mortality after MT among patients with COVID-19 is not negligible. Abnormalities of lymphocyte count, LDH and aspartate may depict a patient’s profiles with poorer outcomes after MT. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT04406090.

AB - Background and Purpose: Acute ischemic stroke and large vessel occlusion can be concurrent with the coronavirus disease 2019 (COVID-19) infection. Outcomes after mechanical thrombectomy (MT) for large vessel occlusion in patients with COVID-19 are substantially unknown. Our aim was to study early outcomes after MT in patients with COVID-19. Methods: Multicenter, European, cohort study involving 34 stroke centers in France, Italy, Spain, and Belgium. Data were collected between March 1, 2020 and May 5, 2020. Consecutive laboratory-confirmed COVID-19 cases with large vessel occlusion, who were treated with MT, were included. Primary investigated outcome: 30-day mortality. Secondary outcomes: early neurological improvement (National Institutes of Health Stroke Scale improvement ≥8 points or 24 hours National Institutes of Health Stroke Scale 0–1), successful reperfusion (modified Thrombolysis in Cerebral Infarction grade ≥2b), and symptomatic intracranial hemorrhage. Results: We evaluated 93 patients with COVID-19 with large vessel occlusion who underwent MT (median age, 71 years [interquartile range, 59–79]; 63 men [67.7%]). Median pretreatment National Institutes of Health Stroke Scale and Alberta Stroke Program Early CT Score were 17 (interquartile range, 11–21) and 8 (interquartile range, 7–9), respectively. Anterior circulation acute ischemic stroke represented 93.5% of cases. The rate modified Thrombolysis in Cerebral Infarction 2b to 3 was 79.6% (74 patients [95% CI, 71.3–87.8]). Thirty-day mortality was 29% (27 patients [95% CI, 20–39.4]). Early neurological improvement was 19.5% (17 patients [95% CI, 11.8–29.5]), and symptomatic intracranial hemorrhage was 5.4% (5 patients [95% CI, 1.7–12.1]). Patients who died at 30 days exhibited significantly lower lymphocyte count, higher levels of aspartate, and LDH (lactate dehydrogenase). After adjustment for age, initial National Institutes of Health Stroke Scale, Alberta Stroke Program Early CT Score, and successful reperfusion, these biological markers remained associated with increased odds of 30-day mortality (adjusted odds ratio of 2.70 [95% CI, 1.21–5.98] per SD-log decrease in lymphocyte count, 2.66 [95% CI, 1.22–5.77] per SD-log increase in aspartate, and 4.30 [95% CI, 1.43–12.91] per SD-log increase in LDH). Conclusions: The 29% rate of 30-day mortality after MT among patients with COVID-19 is not negligible. Abnormalities of lymphocyte count, LDH and aspartate may depict a patient’s profiles with poorer outcomes after MT. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT04406090.

U2 - 10.1161/STROKEAHA.120.031514

DO - 10.1161/STROKEAHA.120.031514

M3 - Article

VL - 52

SP - 31

EP - 39

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 1

ER -

European Multicenter Study of ET-COVID-19

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