Evidence map›Paper›PMID 32818804›Full record

SynthesisEBioMedicine2020

Risk of stroke in hospitalized SARS-CoV-2 infected patients: A multinational study.

Shima Shahjouei, Soheil Naderi, Jiang Li, Ayesha Khan, Durgesh Chaudhary, Ghasem Farahmand, Shailesh Male, Christoph Griessenauer, Mirna Sabra, Stefania Mondello and 34 more

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in EBioMedicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
72citing papers in PubMed, 12 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

72 citing papers in PubMed, 12 syntheses or guidelines pooled it.

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  5. Neurological and Head/Eyes/Ears/Nose/Throat Manifestations of COVID-19: A Systematic Review and Meta-Analysis.The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques · 2022
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  20. Anticoagulant therapy in COVID-19: A narrative review.Clinical and translational science · 2023
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12 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

44 authors.

Shima ShahjoueiNeurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA.
Soheil NaderiNeurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA; Neurosurgery Department, Tehran University of Medical Sciences, Tehran, Iran.
Jiang LiDepartment of Molecular and Functional Genomics, Geisinger Health System, Danville, PA, USA.
Ayesha KhanNeurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA.
Durgesh ChaudharyNeurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA.
Ghasem FarahmandIranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Neurology Department, Tehran University of Medical Sciences, Tehran, Iran.
Shailesh MaleNeurology Department, Vidant Medical Center, Greenville, NC, USA.
Christoph GriessenauerNeurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA.
Mirna SabraNeurosciences Research Center (NRC), Lebanese University/ Medical School, Beirut, Lebanon.
Stefania MondelloDepartment of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
Achille CernigliaroRegional Health Authority of Sicily, Palermo, Italy.
Faezeh KhodadadiPES University, Bengaluru, Karnataka, India.
Apoorva DevPES University, Bengaluru, Karnataka, India.
Nitin GoyalNeurology Department, University of Tennessee Health Science Center, Tennessee, USA.
Sakineh Ranji-BurachalooIranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Neurology Department, Tehran University of Medical Sciences, Tehran, Iran.
Oluwaseyi OlulanaNeurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA.
Venkatesh AvulaNeurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA.
Seyed Amir EbrahimzadehRadiology Department, Yasrebi Hospital, Kashan, Iran.
Orkhan AlizadaNeurosurgery Department, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey.
Mehmet Murat HancıNeurosurgery Department, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey.
Askar GhorbaniNeurology Department, Tehran University of Medical Sciences, Tehran, Iran.
Alaleh Vaghefi FarDepartment of Neurology, Wellington Hospital, Wellington, New Zealand.
Annemarei RantaDepartment of Neurology, Wellington Hospital, Wellington, New Zealand; Department of Medicine, University of Otago, Wellington, New Zealand.
Martin PunterDepartment of Neurology, Wellington Hospital, Wellington, New Zealand; Department of Medicine, University of Otago, Wellington, New Zealand.
Mahtab RamezaniNeurology Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Nima OstadrahimiNeurosurgery Department, Tehran University of Medical Sciences, Tehran, Iran.
Georgios TsivgoulisNeurology Department, University of Tennessee Health Science Center, Tennessee, USA; Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, "Attikon" University Hospital, Athens, Greece.
Paraskevi C FragkouFourth Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Peyman Nowrouzi-SohrabiStudent Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Emmanouil KarofylakisFourth Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Sotirios TsiodrasFourth Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Saeideh Neshin Aghayari SheikhNeurology Department, Poursina Hospital, Guilan University of Medical Sciences, Guilan, Iran.
Alia SaberiNeurology Department, Poursina Hospital, Guilan University of Medical Sciences, Guilan, Iran.
Mika NiemeläDepartment of Neurosurgery, Helsinki University Hospital, Helsinki, Finland.
Behnam Rezai JahromiDepartment of Neurosurgery, Helsinki University Hospital, Helsinki, Finland.
Ashkan MowlaDivision of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California, California, USA.
Mahsa MashayekhiInternal medicine Department, Tabriz University of medical sciences, Tabriz, Iran.
Reza Bavarsad ShahripourNeurology Department, University of Tennessee Health Science Center, Tennessee, USA.
Seyed Aidin SajediNeuroscience Research Center, Department of Neurology, Golestan University of Medical Sciences, Gorgan, Iran.
Mohammad GhorbaniDivisions of Vascular and Endovascular Neurosurgery and Neurology, Firoozgar Hospital and Rasoul-Akram hospital, Iran University of Medical Sciences, Tehran, Iran.
Arash KiaIcahn school of medicine at Mount Sinai, Department of Population Health Science and Policy, Institute for Healthcare Delivery Science, New York, USA.
Nasrin RahimianNeurology Department, Yasrebi Hospital, Kashan, Iran.
Vida AbediDepartment of Molecular and Functional Genomics, Geisinger Health System, Danville, PA, USA; Biocomplexity Institute, Virginia Tech, Blacksburg, Virginia, USA.
Ramin ZandNeurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA; Neurology Department, University of Tennessee Health Science Center, Tennessee, USA. Electronic address: rzand@geisinger.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is an increased attention to stroke following SARS-CoV-2. The goal of this study was to better depict the short-term risk of stroke and its associated factors among SARS-CoV-2 hospitalized patients.

methodsThis multicentre, multinational observational study includes hospitalized SARS-CoV-2 patients from North and South America (United States, Canada, and Brazil), Europe (Greece, Italy, Finland, and Turkey), Asia (Lebanon, Iran, and India), and Oceania (New Zealand). The outcome was the risk of subsequent stroke. Centres were included by non-probability sampling. The counts and clinical characteristics including laboratory findings and imaging of the patients with and without a subsequent stroke were recorded according to a predefined protocol. Quality, risk of bias, and heterogeneity assessments were conducted according to ROBINS-E and Cochrane Q-test. The risk of subsequent stroke was estimated through meta-analyses with random effect models. Bivariate logistic regression was used to determine the parameters with predictive outcome value. The study was reported according to the STROBE, MOOSE, and EQUATOR guidelines.

findingsWe received data from 26,175 hospitalized SARS-CoV-2 patients from 99 tertiary centres in 65 regions of 11 countries until May 1st, 2020. A total of 17,799 patients were included in meta-analyses. Among them, 156(0.9%) patients had a stroke-123(79%) ischaemic stroke, 27(17%) intracerebral/subarachnoid hemorrhage, and 6(4%) cerebral sinus thrombosis. Subsequent stroke risks calculated with meta-analyses, under low to moderate heterogeneity, were 0.5% among all centres in all countries, and 0.7% among countries with higher health expenditures. The need for mechanical ventilation (OR: 1.9, 95% CI:1.1-3.5, p = 0.03) and the presence of ischaemic heart disease (OR: 2.5, 95% CI:1.4-4.7, p = 0.006) were predictive of stroke.

interpretationThe results of this multi-national study on hospitalized patients with SARS-CoV-2 infection indicated an overall stroke risk of 0.5%(pooled risk: 0.9%). The need for mechanical ventilation and the history of ischaemic heart disease are the independent predictors of stroke among SARS-CoV-2 patients.

fundingNone.

Indexed as

AdultAgedBetacoronavirusCoronavirus InfectionsCOVID-19FemaleHospitalizationHumansMaleMiddle AgedPandemicsPneumonia, ViralRisk FactorsSARS-CoV-2StrokeTertiary Care CentersCerebrovascular disordersCOVID-19Intracranial haemorrhageNeurological complicationsSARS-CoV-2StrokeVenous thrombosis

Identifiers

PMID32818804
PMCPMC7429203

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.