Acute Revascularization Treatment in Ischemic Stroke Patients With COVID-19

Safety and Outcomes of Acute Revascularization Treatment in COVID Patients: an International Comparative Study

Case-series and cohort studies have shown the feasibility of reperfusion therapies in patients with ischemic stroke and COVID-19, but due to the absence of a contemporary control group of non-COVID-19 patients, small sample size or lack of long-term outcome assessment, concerns regarding safety and efficacy of these treatments remain to be clarified. Taking into account its limitations, some studies documented higher rates of endovascular treatment complications such as clot fragmentation with distal embolization and vessel re-oclusion, to be more difficult to achieve recanalization after endovascular treatment, and higher rates of any intracerebral hemmorhage.

The investigators aim is to assess in a large, multicenter and international cohort, the safety and outcomes of acute reperfusion therapies in patients with ischemic stroke and COVID-19, by comparison with a contemporary control group of patients with ischemic stroke and without COVID-19 from the same centers.

1. Inclusion Criteria:

   • Consecutive ischemic stroke patients receiving acute recanalization treatment (intravenous thrombolysis and/or endovascular treatment) up to 24 hours since last time since well, and according to local treatment criteria
   • From 1st of March 2020 (for Chinese Centers from 1st January 2020)

2. Exclusion Criteria:

   • Patients without a PCR- or antigen test within the first 7 days after treatment
   • Patients with nosocomial SARS-CoV-2 infection after receiving acute recanalization treatment - PCR- or antigen test becoming positive more than 7 days after treatment
   • Patients with "Suspect/ probable case of SARS-CoV-2 infection" according to the World Health Organization definition
   • Symptomatic cases of SARS-CoV-2 infection with symptoms resolution more than 7 days before treatment
   • Asymptomatic cases of SARS-CoV-2 infection with treatment performed more than 10 days after first positive test for SARS-CoV-2