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. 2021 Aug;16(5):1247-1252.
doi: 10.1007/s11739-021-02634-x. Epub 2021 Feb 10.

Clinical features and disease course of patients with acute ischaemic stroke just before the Italian index case: Was COVID-19 already there?

Anna M Pietroboni  1   2 , Silvia Lanfranconi  3   4 , Alessio Novella  5 , Tiziana Carandini  3   4 , Andrea Arighi  3   4 , Elena Abati  3   4 , Roberta Brusa  3   4 , Gianluca Costamagna  3   4 , Giulia Lazzeri  3   4 , Eleonora Mauri  3   4 , Mattia Pozzato  3   4 , Luca Sacchi  3   4 , Gloria Valcamonica  3   4 , Davide Villa  3   4 , Sara Bonato  3   4 , Giacomo P Comi  3   4 , Nereo Bresolin  3   4 , Daniela Galimberti  3   4 , Elio Scarpini  3   4 , Alessandro Nobili  5 ; Neurology-COVID-19 Group
Collaborators, Affiliations

Clinical features and disease course of patients with acute ischaemic stroke just before the Italian index case: Was COVID-19 already there?

Anna M Pietroboni et al. Intern Emerg Med. 2021 Aug.

Abstract

Since the end of February 2020, Italy has suffered one of the most severe outbreaks of coronavirus disease 2019 (COVID-19). However, what happened just before the Italian index case has not yet been investigated. To answer this question, we evaluated the potential impact of COVID-19 on the clinical features of a cohort of neurological inpatients admitted right before the Italian index case, as compared to the same period of the previous year. Demographic, clinical, treatment and laboratory data were extracted from medical records. The data collected included all inpatients who had been admitted to the Neurology and Stroke Units of the Ospedale Maggiore Policlinico, Milan, Italy, from December 15, 2018 to February 20, 2019 and from December 15, 2019 to February 20, 2020. Of the 248 patients, 97 subjects (39.1%) were admitted for an acute cerebrovascular event: 46 in the 2018/2019 period (mean [SD] age, 72.3 [15.6] years; 22 men [47.8%]), and 51 in the 2019/2020 interval (mean [SD] age, 72.8 [12.4] years; 24 men [47.1%]). The number of cryptogenic strokes has increased during the 2019-2020 year, as compared to the previous year (30 [58.8%] vs. 18 [39.1%], p = 0.05). These patients had a longer hospitalization (mean [SD] day, 15.7 [10.5] days vs. mean [SD] day, 11.7 [7.2] days, p = 0.03) and more frequent cerebrovascular complications (9 [30.0%] vs. 2 [11.1%]), but presented a lower incidence of cardiocerebral risk factors (18 [60.0%] vs. 14 [77.8%]). Right before the Italian index case, an increase in cryptogenic strokes has occurred, possibly due to the concomitant COVID-19.

Keywords: Acute ischaemic stroke; COVID-19; Cerebrovascular events; Cryptogenic stroke.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
a Bar graph showing the percentage of stroke subtypes in the year 2019/2020 vs. 2018/2019. p = 0.05. b Column graph showing days of hospitalization (mean, SD) in the year 2019–2020 vs. 2018/2019. p = 0.03. c Column graph showing the percentage of cerebrovascular complications in the year 2019/2020 vs. 2018/2019. d Column graph showing the percentage of cardio-cerebrovascular (CCV) risk factors in the year 2019/2020 vs. 2018/2019. e Colum graph showing the percentage of respiratory complications in the year 2019/2020 vs. 20
See this image and copyright information in PMC

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