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Abstract Details

Predictors of Poor Outcome in COVID-19 Patients with Acute Ischemic Stroke
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
017
Identify predictors of poor outcome in patients with COVID-19 disease and Acute Ischemic Stroke (AIS).

SARS-CoV-2 infection is associated with a strong inflammatory and procoagulable state, leading to thromboembolic events. COVID-19 patients with AIS tend to have worse outcomes compared with non-COVID AIS patients.

AIS patients with and without COVID-19 disease, admitted between March 15-May 15, 2020 to one of the six major comprehensive stroke centers from Chicago area were included in this study. Stroke was diagnosed based on neuroimaging findings. SARS-CoV-2 infection was diagnosed based on RT-PCR testing. Patients were dichotomized based on outcome at hospital discharge. Poor outcome was defined as Modified Rankin Scale score (mRS) of 3-6. Univariate and multivariate analyses were developed to identify predictors of outcome.

 Out of 194 patients with AIS, 32% tested positive for SARS-CoV-2 and 60% had poor outcome. In univariate analysis, poor outcome for COVID-19 patients was associated with pre-existing hypertension and higher NIHSS score at stroke onset (p<0.005), while for COVID-19 negative patients poor outcome was associated with age, pre-existing congestive heart failure and lower NIHSS score at stroke onset (p<0.05 for all). When comparing COVID-19 positive and negative patients, predictors of worse outcome were pre-exiting diabetes and renal disease.  COVID-19 negative patients with poor outcome had a higher number of large vessel disease strokes and stroke of other determined etiologies compared with COVID-19 positive patients. In multivariate analysis, diabetes (OR=3.91, 95%CI=1.66-9.23, p=0.002) and renal disease (OR=3.12, 95%CI=1.04-9.60, p=0.04) remained independent predictors of worse outcome for COVID-19 patients compared with non-COVID-19 patients, while stroke mechanisms did not. 

Pre-existing diabetes and renal disease remain the most important predictors of worse outcome in stroke patients with COVID-19 disease. 
Authors/Disclosures
Gabriela Trifan, MD (UIC, Department of Neurology)
PRESENTER 		Dr. Trifan has nothing to disclose.
Fernando D. Goldenberg, MD (University of Chicago) Dr. Goldenberg has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Legal expert review.
Frances Caprio, MD (Northwestern Memorial Hospital) Dr. Caprio has received personal compensation in the range of $0-$499 for serving as a Consultant for Medtronic. Dr. Caprio has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie.
Jose Biller, MD, FACP, FAHA, FÂ鶹´«Ã½Ó³»­ (Loyola University Stritch School of Medicine) Dr. Biller has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wolters Kluwer. Dr. Biller has received publishing royalties from a publication relating to health care.
Michael J. Schneck, MD, FÂ鶹´«Ã½Ó³»­ (Loyola University Chicago, Stritch School of Medicine) An immediate family member of Dr. Schneck has received personal compensation for serving as an employee of Cellcarta. Dr. Schneck has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for HLT Medical. Dr. Schneck has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Miscellaneous legal firms. Dr. Schneck has stock in Baxter Labs. The institution of Dr. Schneck has received research support from NIH.
Aslam Khaja, MD (Northwest Neurology) Dr. Khaja has nothing to disclose.
James R. Brorson, MD (University of Chicago) Dr. Brorson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for National Peer Review Corporation. Dr. Brorson has a non-compensated relationship as a Vascular Neurology Pilot Committee with American Board of Psychiatry and Neurology that is relevant to Â鶹´«Ã½Ó³»­ interests or activities.
Christos Lazaridis, MD Dr. Lazaridis has nothing to disclose.
Zachary B. Bulwa, MD (University of Chicago) Dr. Bulwa has nothing to disclose.
Ronald Alvarado Dyer, MD (The University of Oklahoma Health Campus) Dr. Alvarado Dyer has nothing to disclose.
Faddi G. Saleh Velez, MD (University of oklahoma health Sciences center) Dr. Saleh Velez has nothing to disclose.
Shyam Prabhakaran, MD (University of Chicago) Dr. Prabhakaran has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for University of Cincinnati. Dr. Prabhakaran has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for University of Cincinnati. The institution of Dr. Prabhakaran has received research support from NIH . The institution of Dr. Prabhakaran has received research support from AHRQ. Dr. Prabhakaran has received publishing royalties from a publication relating to health care.
Ayush Batra, MD (Northwestern University) Dr. Batra has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GLG. Dr. Batra has received personal compensation in the range of $0-$499 for serving as a Consultant for Biogenerator Ventures. Dr. Batra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Avania. The institution of Dr. Batra has received research support from GeNeuro SA. The institution of Dr. Batra has received research support from National Institutes of Health. Dr. Batra has received publishing royalties from a publication relating to health care.
Brian Stamm, MD Dr. Stamm has received personal compensation in the range of $10,000-$49,999 for serving as a Physician with Veterans Health Administration.
Nicholas J. Reish, MD, PhD (Northwestern Medical Group) Dr. Reish has nothing to disclose.
Sean D. Ruland, MD (Loyola University Medical Center) Dr. Ruland has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Up to Date. Dr. Ruland has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Law Firms.
Michael Teitcher, MD Dr. Teitcher has nothing to disclose.
Will Taylor, DO (Ascension) Dr. Taylor has nothing to disclose.
James Conners, MD (Rush University Medical Center) The institution of Dr. Conners has received research support from nih.
Eric Liotta, MD (Northwestern University) Dr. Liotta has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Penumbra. The institution of Dr. Liotta has received research support from NIH-NINDS.
Parneet K. Grewal, MD The institution of Dr. Grewal has received research support from Bristol Myer Squibb Foundation. The institution of Dr. Grewal has received research support from IPSEN Global.
Pranusha Pinna, DO Dr. Pinna has nothing to disclose.
Rima Dafer, MD (Rush University Medical Center) Dr. Dafer has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Dafer has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eli Lilly. Dr. Dafer has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Anderson, Rasor, and partners.
Ivan Da Silva, MD Dr. Da Silva has nothing to disclose.
Julianne Hall, MD Dr. Hall has nothing to disclose.
Sayona John, MD, FÂ鶹´«Ã½Ó³»­ (Cook County Health) Dr. John has nothing to disclose.
No disclosure on file
Neelofer Shafi, MD Dr. Shafi has nothing to disclose.
Kristin L. Miller, MD (Northwestern University) Dr. Miller has nothing to disclose.
Bayan Moustafa, DO Dr. Moustafa has nothing to disclose.
Alejandro Vargas, MD, MS, FÂ鶹´«Ã½Ó³»­ (Rush University Medical Center) Dr. Vargas has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer U.S. LLC Pharmaceuticals.
Philip B. Gorelick, MD, MPH, FÂ鶹´«Ã½Ó³»­ Dr. Gorelick has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer. Dr. Gorelick has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AstraZeneca. Dr. Gorelick has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AbbVie. Dr. Gorelick has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AMGEN. Dr. Gorelick has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Gorelick has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi-Genzyme. Dr. Gorelick has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Thorek Memorial Hospital. Dr. Gorelick has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Thorek Memorial Hospital.
Fernando D. Testai, MD, PhD, FÂ鶹´«Ã½Ó³»­ (University of Illinois at Chicago) Dr. Testai has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Testai has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Livingston, Barger, Brandt & Schroeder, L.L.P.. Dr. Testai has received publishing royalties from a publication relating to health care.