{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T00:20:15Z","timestamp":1715732415118},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl_1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:p>\n            <jats:bold>Introduction:<\/jats:bold>\n            Stroke as a presenting feature of COVID-19 infection is being increasingly recognized. The prevalence of malignant middle cerebral artery syndrome (MMC) in acute stroke associated with COVID-19 is yet unknown.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>Methods:<\/jats:bold>\n            This is a retrospective cohort study of ischemic stroke patients admitted in a health center in Brazil. We investigated the prevalence of malignant middle cerebral artery syndrome in COVID-19 and associated stroke patients.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>Results:<\/jats:bold>\n            We included 881 ischemic stroke patients (53% male). COVID-19 patients represented 5.3% (N = 47). Mean age was 65.6 years (SD 13.2). COVID-19 patients were significantly younger (mean: 61.4 years; SD: 13.5; p = 0.025) and disclosed a higher odds of previous ischemic heart disease (OR: 4.1 - CI: 1.98-8.16). The frequency of main stroke risk factors was similar for both groups. COVID-19 patients had significantly higher NIHSS (11 points vs 8.2 in non-Covid-19 group - p = 0.006). MMC occurred more frequently in COVID-19 patients (19.5% vs 4.1% of non-covid-19 group - p &lt; 0.001) (Risk ratio: 5.1; CI: 2.63-10.01 - p &lt; 0.001). COVID-19 stroke patients had a longer hospital stay (p &lt; 0.001) and disclosed a higher risk for in-hospital infection (Risk ratio: 4.3 - CI: 2.47-7.53). Rankin scale at 90 days was significantly higher for COVID-19 patients (p &lt;0.001). Case-fatality was higher among COVID-19 stroke patients (49.4% vs 2.5% in non-covid-19 group; p &lt; 0.0001). Among those patients with MMC, the lethality was significantly higher among COVID-19 patients (66.6% vs 41.3% in non-covid-19 group; p&lt; 0.0001). Multivariate logistic regression with MMC as outcome and adjusted for age, sex, NIHSS and comorbidity index, disclosed COVID-19 infection as the main independent preditor for MMC (OR: 6.3 - CI: 2.26-17.52 - p &lt; 0.0001 - adjusted R2 = 0.2623).\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>Conclusion:<\/jats:bold>\n            In this cohort study, COVID-19 infection was an independent predictor for malignant middle cerebral artery syndrome in ischemic stroke.\n          <\/jats:p>\n          <jats:p>\n            <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" orientation=\"portrait\" position=\"float\" xlink:href=\"g4562.jpg\"\/>\n          <\/jats:p>","DOI":"10.1161\/str.54.suppl_1.tmp9","type":"journal-article","created":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T10:16:12Z","timestamp":1675332972000},"update-policy":"http:\/\/dx.doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Abstract TMP9: Covid-19 Increases The Risk Of Malignant Middle Cerebral Artery Infarction In Acute Stroke"],"prefix":"10.1161","volume":"54","author":[{"given":"Isabel","family":"Santos","sequence":"first","affiliation":[{"name":"Sao Paulo, Brazil"}]},{"given":"Gabriella","family":"Dousseau","sequence":"additional","affiliation":[{"name":"Sao Paulo, Brazil"}]},{"given":"Luisa","family":"Avezum","sequence":"additional","affiliation":[{"name":"Neurology, Hosp Santa Marcelina, Sao Paulo, Brazil"}]},{"given":"Mariana","family":"Piva","sequence":"additional","affiliation":[{"name":"Sao Paulo, Brazil"}]},{"given":"Mateus","family":"Tolentino","sequence":"additional","affiliation":[{"name":"Sao Paulo, Brazil"}]},{"given":"Igor","family":"Terehoff","sequence":"additional","affiliation":[{"name":"Sao Paulo, Brazil"}]},{"given":"Pedro","family":"Domingues","sequence":"additional","affiliation":[{"name":"Sao Paulo, Brazil"}]},{"given":"Nalcer","family":"Canedo","sequence":"additional","affiliation":[{"name":"Neurology, Hosp Santa Marcelina, Sao Paulo, Brazil"}]},{"given":"Michel","family":"Machado","sequence":"additional","affiliation":[{"name":"Sao Paulo, Brazil"}]},{"given":"Maria Sheila G","family":"Rocha","sequence":"additional","affiliation":[{"name":"HOSPITAL SANTA MARCELINA, Sao Paulo, Brazil"}]}],"member":"276","container-title":["Stroke"],"original-title":[],"language":"en","deposited":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T05:33:48Z","timestamp":1715664828000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/str.54.suppl_1.TMP9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2]]},"references-count":0,"journal-issue":{"issue":"Suppl_1","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1161\/str.54.suppl_1.TMP9"],"URL":"https:\/\/doi.org\/10.1161\/str.54.suppl_1.tmp9","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2]]},"assertion":[{"value":"2023-02-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}