Thrombolysis and bridging therapy in patients with acute ischaemic stroke and Covid‐19

• DOI: 10.1111/ene.14511
• Publication Date: 2020-09-21T07:25:49Z
• Authors: M. Cappellari; A. Zini; D. Sangalli; A. Cavallini; M. Reggiani; F. N. Sepe; N. Rifino; G. Giussani; D. Guidetti; M. Zedde; S. Marcheselli; M. Longoni; S. Beretta; V. Sidoti; D. M. Papurello; A. Giossi; P. Nencini; M. Plocco; M. Balestrino; E. Rota; D. Toni
• Keywords: Stroke; Acute stroke; Ischaemic stroke

Background and purpose Comorbidity of acute ischaemic stroke with Covid‐19 is a challenging condition, potentially influencing the decision whether to administer intravenous thrombolysis (IVT). We aimed assess 1‐month outcome in patients infection who received IVT alone or before thrombectomy (bridging therapy). Methods As collaboration initiative promoted by Italian Stroke Organization, all units ( n = 190) were contacted invited participate data collection on IVT. Results Seventy‐five centers agreed participate. Thirty 17 bridging therapy between 21 February 2020 30 April 20 18, Northern Italy; 2, Central Italy). At 1 month, 14 (30.4%) died (62.5%) survivors had modified Rankin Scale (mRS) score 3 5. 24 36 hours, asymptomatic intracerebral hemorrhage (ICH) was reported eight (17.4%) symptomatic ICH (sICH) two (4.3%) patients. Causes death severe 8), new 2), respiratory failure 1), renal myocardial infarction endocarditis 1). In mRS 5, baseline glucose level higher, whereas endovascular procedure time cases longer. Baseline National Institutes Health creatinine levels higher died. Conclusions Intravenous for not rare event most affected areas pandemic, rates unfavorable outcomes high compared previous from pre–Covid‐19 literature. However, risk sICH increased.