孟加拉国转诊神经病学医院卒中专科收治的COVID-19患者的卒中模式和短期预后

S. Das, R. Chowdhury, Moniruzzaman, M. E. Hussain, Q. Mohammad, B. A. Mondal, Jahirul Haque Chowdhury
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摘要

背景:世卫组织于2020年3月11日宣布COVID-19为大流行。虽然最常见和最重要的表现是呼吸系统疾病,但有关神经系统特征的报道也在增加。目的:在本研究中,描述了在专门的卒中单元住院的COVID-19患者的卒中模式及其短期预后。方法:这项单臂、单中心前瞻性队列研究于2020年4月至8月在孟加拉国达卡国家神经科学和医院研究所卒中部进行,纳入了SARS CoV-2 RT-PCR阳性的急性卒中患者,不论年龄和性别。对患者进行临床、生化和影像学评价。确诊后,患者被转介到专门的covid医院,并从入院之日起在中风病房进行了4周的电话随访,以评估短期结果。结果41例患者中,男性21例,女性20例,年龄26 ~ 90岁,其中60岁及以上患者占58.5%。其中大多数(58.5%)来自不同的城市地区。常见的合并症是高血压(68.3%)和糖尿病(39%)。最常见的表现为偏瘫(48.8%)和意识水平改变(39%)。超过70%(70.7%)的患者GCS为10或更低,56.1%的患者在室内空气中氧饱和度为90%或更低。CT脑显像显示梗死39%,出血51.2%。胸片显示异常14.6%。短期预后方面,共有20例(48.8%)患者死亡,其中7例在转诊至COVID-19专科医院前死亡。出血性卒中死亡率较高,但预后与卒中类型无显著相关性(p值>0.05)。结论:出血性卒中是COVID-19患者中最常见的卒中,且与预后不良相关。《孟加拉国国家神经科学研究所杂志》,2021年1月,第7卷,第1期,第25-28页
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pattern of Stroke and Short Term Outcome of COVID-19 Patients admitted in a Dedicated Stroke Unit at Referral Neurology Hospital of Bangladesh
Background: COVID-19 was declared as a pandemic by WHO on March 11, 2020. Though the most common and important presentation is with respiratory disease, reports of neurological features are increasing. Objective: In this study it was described the pattern of stroke in COVID-19 patients admitted in a dedicated stroke unit and their short term outcome. Methodology: This single arm, single centreprospective cohortstudy was conducted in the Stroke Unit of National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from April to August, 2020 and wasincluded acute stroke patients irrespective of age and sex who were found RT-PCR positive for SARS CoV-2. The patientswere evaluated clinically, biochemically and by imaging. After diagnosis patients were referred to a COVIDdedicated hospital and were followed up over phone for 4 weeks from the day of admission in stroke unit to assess short term outcome. Results: Among the 41 patients, 21 were male and 20 female with an age range of 26 to 90 years where 58.5% patients were aged 60 and above. Majority (58.5%) of them came from different urban areas. Common co-morbidities were Hypertension (68.3%) and Diabetes mellitus (39%). Most common presenting features were hemiplegia (48.8%) and altered level of consciousness (39%). More than seventy percent (70.7%) patients had GCS of 10 or less and 56.1% patients had oxygen saturation 90% or less in room air. CT brain imaging revealed infarct in 39% and hemorrhage in 51.2%. Chest radiography revealed abnormality in 14.6% cases. Regarding the short term outcome, total 20 (48.8%) patients died where 7 died before referral to COVID-19 dedicated hospital. Death was higher in hemorrhagic stroke but there was no significant association between outcome and the type of stroke (p value>0.05). Conclusions: Hemorrhagic stroke is the most commonly occurring stroke among the COVID-19 patients and associated with p oor outcome. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 25-28
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