Xin-Yu Ji1, Yan Ma1, Nan-Nan Shi1, Ning Liang1, Ren-Bo Chen1, Si-Hong Liu2, Shuai Shi3, Gui-Hui Wu4, Ji-Ke Li5, Hong Chen6, Jing-Wei Wang7, Hui Na7, Ying-Chun Zhou8, Min-Qing Li9, Yu-Dong Wang10, Xiao-Mei Hu11, Yun-Hong Hu12, Zhang Liu13, Hai-Jun Xie14, Lin-Song Zhang15, Hua-Min Zhang16, Yan-Ping Wang17, Yong-Yan Wang18. 1. Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China. 2. Institute of Information on Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China. 3. Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China. 4. Department of tuberculosis, The Public Health Clinical Center of Chengdu, Sichuan, China. 5. Department of traditional Chinese medicine, The Public Health Clinical Center of Chengdu, Sichuan, China. 6. President's office, The First Hospital of Qiqiha, Heilongjiang, China. 7. Department of infectious disease, Harbin Infectious Disease Hospital, Heilongjiang, China. 8. Department of infectious disease, Shuangyashan People's Hospital, Heilongjiang, China. 9. Department of traditional Chinese medicine, Dazhou Central Hospital, Sichuan, China. 10. Hengshui Hospital of Chinese Medicine, Hebei, China. 11. Department of traditional Chinese medicine, Langfang Hospital of Chinese Medicine, Hebei, China. 12. Department of traditional Chinese medicine, Xingtai Hospital of Chinese Medicine, Hebei, China. 13. Department of traditional Chinese medicine, The First Hospital of Suihua City, Heilongjiang, China. 14. Department of infectious disease, Xinzhou People's Hospital, Shanxi, China. 15. Department of traditional Chinese medicine, Hospital (T•C•M) Affiliated to Southwest Medical University, Sichuan, China. 16. Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China. Electronic address: zhanghm@mail.cintcm.ac.cn. 17. Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China. Electronic address: wangyanping4816@163.com. 18. Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China. Electronic address: wangyongyan1938@126.com.
Abstract
OBJECTIVE: Previous studies mainly reported the clinical characteristics of novel coronavirus 2019 (COVID-19) infections, but the research on clinical characteristics and treatment outcomes of COVID-19 patients with stroke is still rare. METHODS: A multi-center retrospective study was conducted at 11 hospitals in 4 provinces of China, and COVID-19 patients with stroke were enrolled from February 24 to May 4, 2020. We analyzed epidemiological, demographic, and clinical characteristics of cases as well as the laboratory test results, treatment regimens and outcomes, and the clinical characteristics and therapeutic outcomes were compared between severe and nonsevere patients, and by age group, respectively. RESULTS: A total of 27 patients [mean age: 66.41 (SD 12.1) years] were enrolled. Among them, 9 (33.3%) were severe patients and 18 (66.7%) were nonsevere patients; 17 (63.0%) were female; 19 (70.4%) were aged 60 years and above. The most common symptoms were fever [19 (70.4%)], fatigue [12 (44.4%)] and cough [11 (40.7%)], respectively. Abnormal laboratory findings of COVID-19 patients with stroke included high levels of C-reactive protein [19 (73.1%)], D-dimer [14 (58.3%)], blood glucose [14 (53.8%)], fibrinogen [13 (50.0%)], and decreased lymphocytes [12 (44.4%)]. Comparing to nonsevere cases with stroke, severe patients with stroke were likely to be older, susceptible to receiving oxygen inhalation, and had more complications (p < 0.05). In addition, there were significant differences in lymphocytes, neutrophils, lactate dehydrogenase, C-reactive protein, creatine kinase between the severe cases and nonsevere cases (p < 0.05). The older patients had a decreased platelet count and elevated fibrinogen, compared with the younger (p < 0.05). All patients (100%) received antiviral treatment, 12 (44.4%) received antibiotics treatment, 26 (96.3%) received Traditional Chinese Medicine (Lung cleansing & detoxifying decoction), and oxygen inhalation was in 18 (66.7%). The median duration of hospitalization was 16 days. By May 4, 2020, a total of 26 (96.3%) patients were cured and discharged, and 1 (3.7%) patients died. CONCLUSION: COVID-19 patients with stroke had poor indicators of coagulation system, and severe and older patients might have a higher risk of complications and unfavorable coagulation system. However, the overall treatment outcome is favorable.
OBJECTIVE: Previous studies mainly reported the clinical characteristics of novel coronavirus 2019 (COVID-19) infections, but the research on clinical characteristics and treatment outcomes of COVID-19patients with stroke is still rare. METHODS: A multi-center retrospective study was conducted at 11 hospitals in 4 provinces of China, and COVID-19patients with stroke were enrolled from February 24 to May 4, 2020. We analyzed epidemiological, demographic, and clinical characteristics of cases as well as the laboratory test results, treatment regimens and outcomes, and the clinical characteristics and therapeutic outcomes were compared between severe and nonsevere patients, and by age group, respectively. RESULTS: A total of 27 patients [mean age: 66.41 (SD 12.1) years] were enrolled. Among them, 9 (33.3%) were severe patients and 18 (66.7%) were nonsevere patients; 17 (63.0%) were female; 19 (70.4%) were aged 60 years and above. The most common symptoms were fever [19 (70.4%)], fatigue [12 (44.4%)] and cough [11 (40.7%)], respectively. Abnormal laboratory findings of COVID-19patients with stroke included high levels of C-reactive protein [19 (73.1%)], D-dimer [14 (58.3%)], blood glucose [14 (53.8%)], fibrinogen [13 (50.0%)], and decreased lymphocytes [12 (44.4%)]. Comparing to nonsevere cases with stroke, severe patients with stroke were likely to be older, susceptible to receiving oxygen inhalation, and had more complications (p < 0.05). In addition, there were significant differences in lymphocytes, neutrophils, lactate dehydrogenase, C-reactive protein, creatine kinase between the severe cases and nonsevere cases (p < 0.05). The older patients had a decreased platelet count and elevated fibrinogen, compared with the younger (p < 0.05). All patients (100%) received antiviral treatment, 12 (44.4%) received antibiotics treatment, 26 (96.3%) received Traditional Chinese Medicine (Lung cleansing & detoxifying decoction), and oxygen inhalation was in 18 (66.7%). The median duration of hospitalization was 16 days. By May 4, 2020, a total of 26 (96.3%) patients were cured and discharged, and 1 (3.7%) patientsdied. CONCLUSION:COVID-19patients with stroke had poor indicators of coagulation system, and severe and older patients might have a higher risk of complications and unfavorable coagulation system. However, the overall treatment outcome is favorable.