Impact of Vaccination Status on Outcome of Patients With COVID‐19 and Acute Ischemic Stroke Undergoing Mechanical Thrombectomy

Journal of the American Heart Association, vol. 13, pp. e031816

Abstract

Background Data on impact of COVID‐19 vaccination and outcomes of patients with COVID‐19 and acute ischemic stroke undergoing mechanical thrombectomy are scarce. Addressing this subject, we report our multicenter experience. Methods and Results This was a retrospective analysis of patients with COVID‐19 and known vaccination status treated with mechanical thrombectomy for acute ischemic stroke at 20 tertiary care centers between January 2020 and January 2023. Baseline demographics, angiographic outcome, and clinical outcome evaluated by the modified Rankin Scale score at discharge were noted. A multivariate analysis was conducted to test whether these variables were associated with an unfavorable outcome, defined as modified Rankin Scale score >3. A total of 137 patients with acute ischemic stroke (48 vaccinated and 89 unvaccinated) with acute or subsided COVID‐19 infection who underwent mechanical thrombectomy attributable to vessel occlusion were included in the study. Angiographic outcomes between vaccinated and unvaccinated patients were similar (modified Thrombolysis in Cerebral Infarction ≥2b: 85.4% in vaccinated patients versus 86.5% in unvaccinated patients; P =0.859). The rate of functional independence (modified Rankin Scale score, ≤2) was 23.3% in the vaccinated group and 20.9% in the unvaccinated group ( P =0.763). The mortality rate was 30% in both groups. In the multivariable analysis, vaccination status was not a significant predictor for an unfavorable outcome ( P =0.957). However, acute COVID‐19 infection remained significant (odds ratio, 1.197 [95% CI, 1.007–1.417]; P =0.041). Conclusions Our study demonstrated no impact of COVID‐19 vaccination on angiographic or clinical outcome of COVID‐19–positive patients with acute ischemic stroke undergoing mechanical thrombectomy, whereas worsening attributable to COVID‐19 was confirmed.

Authors 43

1. Cornelius Deuschl

   Essen University Hospital

   Affiliation as printed

   Institute for Diagnostic and Interventional Radiology and Neuroradiology University Hospital Essen Essen Germany

2. Lukas Goertz

   University Hospital Cologne

   Affiliation as printed

   Department of Diagnostic and Interventional Radiology University Hospital Cologne Cologne Germany

   Lukas Goertz https://orcid.org/0000-0002-2620-7611 , Department of Diagnostic and Interventional Radiology, , University Hospital Cologne, , Cologne, , Germany,

3. Christoph Kabbasch

   University Hospital Cologne

   Affiliation as printed

   Department of Diagnostic and Interventional Radiology University Hospital Cologne Cologne Germany

   Christoph Kabbasch https://orcid.org/0000-0003-3712-2258 , Department of Diagnostic and Interventional Radiology, , University Hospital Cologne, , Cologne, , Germany,

4. Martin Köhrmann

   Essen University Hospital

   Affiliation as printed

   Department of Neurology and Center for Translational Neurosciences and Behavioral Sciences University Hospital Essen Essen Germany

5. Christoph Kleinschnitz

   Essen University Hospital · Stiftung Universitätsmedizin Essen

   Affiliation as printed

   Department of Neurology and Center for Translational Neurosciences and Behavioral Sciences University Hospital Essen Essen Germany

   Christoph Kleinschnitz https://orcid.org/0000-0002-1650-8875 , Department of Neurology and Center for Translational Neurosciences and Behavioral Sciences, , University Hospital Essen, , Essen, , Germany,

6. Ansgar Berlis

   University Hospital Augsburg

   Affiliation as printed

   Department of Diagnostic and Interventional Neuroradiology University Hospital Augsburg Augsburg Germany

   Ansgar Berlis https://orcid.org/0000-0001-5321-5118 , Department of Diagnostic and Interventional Neuroradiology, , University Hospital Augsburg, , Augsburg, , Germany,

7. Christoph Johannes Maurer

   University Hospital Augsburg

   Affiliation as printed

   Department of Diagnostic and Interventional Neuroradiology University Hospital Augsburg Augsburg Germany

   Christoph Johannes Maurer https://orcid.org/0000-0002-0305-0797 , Department of Diagnostic and Interventional Neuroradiology, , University Hospital Augsburg, , Augsburg, , Germany,

8. Iris Muehlen

   Friedrich-Alexander-Universität Erlangen-Nürnberg

   Affiliation as printed

   Department of Neuroradiology University of Erlangen‐Nuremberg Erlangen Germany

9. Bernd Kallmünzer

   Friedrich-Alexander-Universität Erlangen-Nürnberg

   Affiliation as printed

   Department of Neurology University of Erlangen‐Nuremberg Erlangen Germany

10. Matthias Gawlitza

    Technische Universität Dresden · University Hospital Carl Gustav Carus · University Hospital Leipzig

    Affiliation as printed

    Department of Neuroradiology University Hospital Leipzig Leipzig Germany

    Faculty of Medicine, Institute and Policlinic of Neuroradiology, University Hospital Carl Gustav Carus Technische Universität Dresden Dresden Germany

11. Daniel P. O. Kaiser

    Technische Universität Dresden · University Hospital Carl Gustav Carus

    Affiliation as printed

    Faculty of Medicine, Institute and Policlinic of Neuroradiology, University Hospital Carl Gustav Carus Technische Universität Dresden Dresden Germany

12. Joachim Klisch

    Helios Klinikum Erfurt

    Affiliation as printed

    Department of Diagnostic and Interventional Radiology and Neuroradiology Helios General Hospital Erfurt Erfurt Germany

    Joachim Klisch , Department of Diagnostic and Interventional Radiology and Neuroradiology, , Helios General Hospital Erfurt, , Erfurt, , Germany,

13. Donald Lobsien

    Helios Klinikum Erfurt

    Affiliation as printed

    Department of Diagnostic and Interventional Radiology and Neuroradiology Helios General Hospital Erfurt Erfurt Germany

    Donald Lobsien , Department of Diagnostic and Interventional Radiology and Neuroradiology, , Helios General Hospital Erfurt, , Erfurt, , Germany,

14. Daniel Behme

    University Hospital Magdeburg

    Affiliation as printed

    Department of Neuroradiology University Hospital Magdeburg Magdeburg Germany

    Daniel Behme https://orcid.org/0000-0002-5353-9515 , Department of Neuroradiology, , University Hospital Magdeburg, , Magdeburg, , Germany,

15. Maximilian Thormann

    University Hospital Magdeburg

    Affiliation as printed

    Department of Radiology University Hospital Magdeburg Magdeburg Germany

    Maximilian Thormann https://orcid.org/0000-0003-3822-8871 , Department of Radiology, , University Hospital Magdeburg, , Magdeburg, , Germany,

16. Fabian Flottmann

    University Medical Center Hamburg-Eppendorf

    Affiliation as printed

    Department of Diagnostic and Interventional Neuroradiology University Medical Center Hamburg‐Eppendorf Hamburg Germany

17. Laurens Winkelmeier

    University Medical Center Hamburg-Eppendorf

    Affiliation as printed

    Department of Diagnostic and Interventional Neuroradiology University Medical Center Hamburg‐Eppendorf Hamburg Germany

18. Elke Ruth Gizewski

    Innsbruck Medical University · Universität Innsbruck

    Affiliation as printed

    Department of Neuroradiology Medical University Innsbruck Innsbruck Austria

    Elke Ruth Gizewski https://orcid.org/0000-0001-6859-8377 , Department of Neuroradiology, , Medical University Innsbruck, , Innsbruck, , Austria,

19. Lukas Mayer‐Suess

    Innsbruck Medical University · Universität Innsbruck

    Affiliation as printed

    Department of Neurology Medical University Innsbruck Innsbruck Austria

20. Markus Holtmannspoetter

    Nuremberg Hospital

    Affiliation as printed

    Department of Neuroradiology Nuremberg General Hospital Nuremberg Germany

    Markus Holtmannspoetter https://orcid.org/0000-0003-2536-5244 , Department of Neuroradiology, , Nuremberg General Hospital, , Nuremberg, , Germany,

21. Christoph Mönninghoff

    Ruhr University Bochum · University Hospitals of the Ruhr-University of Bochum

    Affiliation as printed

    Department of Radiology, Neuroradiology and Nuclear Medicine Johannes Wesling University Hospital, Ruhr University Bochum Bochum Germany

    Christoph Moenninghoff https://orcid.org/0000-0003-3946-9386 , Department of Radiology, Neuroradiology and Nuclear Medicine, , Johannes Wesling University Hospital, Ruhr University Bochum, , Bochum, , Germany,

22. Martin Schlunz‐Hendann

    Sana Kliniken Duisburg

    Affiliation as printed

    Department of Radiology and Neuroradiology Klinikum Duisburg–Sana Kliniken Duisburg Germany

23. Dominik Grieb

    Medizinische Hochschule Hannover · Sana Kliniken Duisburg

    Affiliation as printed

    Department of Diagnostic and Interventional Neuroradiology Medical School Hannover Hannover Germany

    Department of Radiology and Neuroradiology Klinikum Duisburg–Sana Kliniken Duisburg Germany

24. Christophe Théo Arendt

    University Hospital Frankfurt · Goethe University Frankfurt

    Affiliation as printed

    Institute of Neuroradiology, University Hospital Goethe University Frankfurt am Main Germany

    Christophe T. Arendt https://orcid.org/0000-0003-3300-3729 , Institute of Neuroradiology, University Hospital, , Goethe University, , Frankfurt am Main, , Germany,

25. Ferdinand Oliver Bohmann

    University Hospital Frankfurt · Goethe University Frankfurt

    Affiliation as printed

    Institute of Neuroradiology, University Hospital Goethe University Frankfurt am Main Germany

    Ferdinand O. Bohmann https://orcid.org/0000-0001-6439-0667 , Institute of Neuroradiology, University Hospital, , Goethe University, , Frankfurt am Main, , Germany,

26. Jens Altenbernd

    Gemeinschaftskrankenhaus Herdecke

    Affiliation as printed

    Department of Radiology and Neuroradiology Gemeinschaftskrankenhaus Herdecke Herdecke Germany

    Jens Altenbernd https://orcid.org/0000-0003-4780-6960 , Department of Radiology and Neuroradiology, , Gemeinschaftskrankenhaus Herdecke, , Herdecke, , Germany,

27. Yan Li

    Essen University Hospital

    Affiliation as printed

    Institute for Diagnostic and Interventional Radiology and Neuroradiology University Hospital Essen Essen Germany

    Yan Li https://orcid.org/0000-0002-3906-9481 , Institute for Diagnostic and Interventional Radiology and Neuroradiology, , University Hospital Essen, , Essen, , Germany,

28. Ulrich Sure

    Essen University Hospital

    Affiliation as printed

    Department of Neurosurgery and Spine Surgery University Hospital of Essen Essen Germany

    Ulrich Sure https://orcid.org/0000-0002-9073-1821 , Department of Neurosurgery and Spine Surgery, , University Hospital of Essen, , Essen, , Germany,

29. Ruben Mühl‐Benninghaus

    Klinikum Lüneburg

    Affiliation as printed

    Department of Radiology Klinikum Lueneburg Lueneburg Germany

30. Thomas Rodt

    Klinikum Lüneburg

    Affiliation as printed

    Department of Radiology Klinikum Lueneburg Lueneburg Germany

    Thomas Rodt , Department of Radiology, , Klinikum Lueneburg, , Lueneburg, , Germany,

31. Kai Kallenberg

    Klinikum Fulda

    Affiliation as printed

    Department of Neuroradiology Klinikum Fulda Fulda Germany

    Kai Kallenberg https://orcid.org/0000-0001-6052-8702 , Department of Neuroradiology, , Klinikum Fulda, , Fulda, , Germany,

32. Alexandru Durutya

    Klinikum Fulda

    Affiliation as printed

    Department of Neuroradiology Klinikum Fulda Fulda Germany

    Alexandru Durutya , Department of Neuroradiology, , Klinikum Fulda, , Fulda, , Germany,

33. Mohamed Elsharkawy

    University Hospital Münster

    Affiliation as printed

    Clinic for Radiology University Hospital Muenster Muenster Germany

    Mohamed Elsharkawy , Clinic for Radiology, , University Hospital Muenster, , Muenster, , Germany,

34. Christian Paul Stracke

    University Hospital Münster

    Affiliation as printed

    Clinic for Radiology University Hospital Muenster Muenster Germany

35. Mathias Gerhard Schumann

    Vivantes Klinikum

    Affiliation as printed

    Department of Neuroradiology Vivantes Klinikum Neukoelln Berlin Germany

    Mathias Gerhard Schumann , Department of Neuroradiology, , Vivantes Klinikum Neukoelln, , Berlin, , Germany,

36. Alexander Bock

    Vivantes Klinikum

    Affiliation as printed

    Department of Neuroradiology Vivantes Klinikum Neukoelln Berlin Germany

    Alexander Bock , Department of Neuroradiology, , Vivantes Klinikum Neukoelln, , Berlin, , Germany,

37. Omid Nikoubashman Aachen Department of Diagnostic and Interventional Neuroradiology

    RWTH Aachen University · Universitätsklinikum Aachen

    Affiliation as printed

    Department of Diagnostic and Interventional Neuroradiology University Hospital, Rheinisch‐Westfälische Technische Hochschule Aachen University Aachen Germany

38. Martin Wiesmann Aachen Department of Diagnostic and Interventional Neuroradiology

    RWTH Aachen University · Universitätsklinikum Aachen

    Affiliation as printed

    Department of Diagnostic and Interventional Neuroradiology University Hospital, Rheinisch‐Westfälische Technische Hochschule Aachen University Aachen Germany

39. Hans H. Henkes

    Klinikum Stuttgart

    Affiliation as printed

    Clinic for Neuroradiology Klinikum Stuttgart Stuttgart Germany

    Hans Henkes https://orcid.org/0000-0002-6534-036X , Clinic for Neuroradiology, , Klinikum Stuttgart, , Stuttgart, , Germany,

40. Sebastian Dolff

    Essen University Hospital · Stiftung Universitätsmedizin Essen

    Affiliation as printed

    Department of Infectious Diseases, West German Centre of Infectious Diseases University Hospital Essen Essen Germany

    Sebastian Dolff https://orcid.org/0000-0001-5549-1706 , Department of Infectious Diseases, West German Centre of Infectious Diseases, , University Hospital Essen, , Essen, , Germany,

41. Aydın Demircioğlu

    Essen University Hospital

    Affiliation as printed

    Institute for Diagnostic and Interventional Radiology and Neuroradiology University Hospital Essen Essen Germany

    Aydin Demircioglu https://orcid.org/0000-0003-0349-5590 , Institute for Diagnostic and Interventional Radiology and Neuroradiology, , University Hospital Essen, , Essen, , Germany,

42. Michael Forsting

    Essen University Hospital

    Affiliation as printed

    Institute for Diagnostic and Interventional Radiology and Neuroradiology University Hospital Essen Essen Germany

    Michael Forsting , Institute for Diagnostic and Interventional Radiology and Neuroradiology, , University Hospital Essen, , Essen, , Germany,

43. Hanna Styczen

    Essen University Hospital

    Affiliation as printed

    Institute for Diagnostic and Interventional Radiology and Neuroradiology University Hospital Essen Essen Germany

    Hanna Styczen , Institute for Diagnostic and Interventional Radiology and Neuroradiology, , University Hospital Essen, , Essen, , Germany,