Pronóstico de pacientes COVID-19 con ictus isquémico y tratamiento neurointervencionista

Objective We report our experience and analyse the prognosis of acute ischaemic stroke due to large vessel occlusion (LVO) in patients with COVID-19 receiving neurointerventional treatment. Material and methods The study included all consecutive patients with acute ischaemic stroke due to LVO treated with neurointerventional techniques at our institution in March and April 2020, during the COVID-19 outbreak, and compared patients with and without COVID-19. Baseline and short-term clinical data were reported. Results From 1 March to 30 April 2020, 25 neurointerventional procedures were performed to treat acute ischaemic stroke due to LVO at our institution. Eight patients had COVID-19 and 17 did not. The mean age (SD) of patients with COVID-19 was 70.1 (12.23) years, and 7 were men (87.5%, P=.006). While all 17 patients without COVID-19 were referred from the emergency department, only 5 (62.5%) COVID-19 patients were treated for stroke at the emergency department (P=.01). Three patients had to be hospitalised. The mortality rate was considerably higher among patients with COVID-19 (50%, vs 5.5% in patients without COVID-19). Both groups presented similar laboratory parameters. No haemorrhages were recorded in this series. We observed a 39% decrease in neurointerventional procedures in comparison with the same period the previous year. Conclusions The best medical and neurointerventional treatment resulted in poor outcomes and a dramatic mortality rate. The COVID-19 pandemic significantly disrupted the normal functioning of stroke management in emergency departments.