Risk of stroke in hospitalized SARS-CoV-2 infected patients: A multinational study

Background: There is an increased attention to stroke following SARS-CoV-2. The goal of this study was to better depict the short-term risk of stroke and its associated factors among SARS-CoV-2 hospitalized patients. Methods: This multicentre, multinational observational study includes hospitalized SARS-CoV-2 patients from North and South America (United States, Canada, and Brazil), Europe (Greece, Italy, Finland, and Turkey), Asia (Lebanon, Iran, and India), and Oceania (New Zealand). The outcome was the risk of subsequent stroke. Centres were included by non-probability sampling. The counts and clinical characteristics including laboratory findings and imaging of the patients with and without a subsequent stroke were recorded according to a predefined protocol. Quality, risk of bias, and heterogeneity assessments were conducted according to ROBINS-E and Cochrane Q-test. The risk of subsequent stroke was estimated through meta-analyses with random effect models. Bivariate logistic regression was used to determine the parameters with predictive outcome value. The study was reported according to the STROBE, MOOSE, and EQUATOR guidelines. Findings: We received data from 26,175 hospitalized SARS-CoV-2 patients from 99 tertiary centres in 65 regions of 11 countries until May 1st, 2020. A total of 17,799 patients were included in meta-analyses. Among them, 156(0.9) patients had a stroke�123(79) ischaemic stroke, 27(17) intracerebral/subarachnoid hemorrhage, and 6(4) cerebral sinus thrombosis. Subsequent stroke risks calculated with meta-analyses, under low to moderate heterogeneity, were 0.5 among all centres in all countries, and 0.7 among countries with higher health expenditures. The need for mechanical ventilation (OR: 1.9, 95 CI:1.1�3.5, p = 0.03) and the presence of ischaemic heart disease (OR: 2.5, 95 CI:1.4�4.7, p = 0.006) were predictive of stroke. Interpretation: The results of this multi-national study on hospitalized patients with SARS-CoV-2 infection indicated an overall stroke risk of 0.5(pooled risk: 0.9). The need for mechanical ventilation and the history of ischaemic heart disease are the independent predictors of stroke among SARS-CoV-2 patients. Funding: None. © 2020 The Author

Numerical investigation of heat transfer in a helically coiled tube using copper/water nano-fluid under constant heat flux and prediction of the results using perceptron and radial basis function networks

This study investigated the numerical analysis of Nusselt number and entropy generation of copper/water nano-fluid under turbulent flow conditions at volume fraction ranges of 1�5 within a helical coil under constant heat flux. The nano-fluid behavior was modeled through a single-phase model. Flow and heat transfer governing equations were discretized using finite volume method, and the SIMPLE algorithm was used to solve pressure-velocity coupling equations. The turbulence modelling was done by k-ε turbulence model in ANSYS FLUENT 15. Then, the examination and prediction of the resulted data were carried out using perceptron and radial basis function networks. The innovation of the present study was the application of an unsupervised method (namely, SOM) to specify the winner neuron. Input data of the artificial network included Reynolds number, input temperature, constant heat flux, nano-fluid thermal conductivity coefficient and nano-fluid volume fraction, while output parameters included Nusselt number and total entropy generation. The results showed that Nusselt number, entropy generation yielded from heat transfer, and friction increased as the Reynolds number increased. With an increase in the volume fraction, entropy generation yielded from heat transfer and friction decreased and increased, respectively. The results of artificial networks revealed that self-organizing map (SOM) model had 25 neurons, possessing the highest amount of data. Moreover, Mean Squared Error (MSE), correlation coefficient, and maximum error, Nusselt number and total entropy generation for perceptron neural network were 5.0103,0.996,9.1865, 4.389 � 10�5, and 0.998,0.0259, respectively, confirming a successful prediction. In addition to radial basis function networks, the values of Mean Squared Error (MSE), Root Mean Squared Error (RMSE), standard deviation(�) and a kind of Error(μ) for Nusselt number and entropy generation total were 8.2255 � 10�8,0.0002868,0.00028718,4.741 � 10�6 and 6.0157 � 10�8,0.00024527,0.00024549,7.9006 � 10�6, respectively. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature

Aluminum Oxide Nanofluid Energy Transfer

Nanofluid is a new class of heat transfer fluids engineered by dispersing metallic or non-metallic nanoparticles with a typical size of less than 100 nm in the conventional heat transfer fluids.This article aims to investigate the overall and convection heat transfer coefficient and Nusselt number of Al2O3-water nanofluid flowing in a horizontal double pipe heat exchanger under turbulent flow () conditions. Al2O3 nanoparticles with diameter of 20 nm dispersed in Deionized water with volume concentrations of  vol. are used as the test fluid. The results show that the overall and convection heat transfer coefficient and Nusselt number of nanofluid were approximately 15% -21% greater than that of pure fluid. Additionally, the heat transfer coefficient and Nusselt number increase with an increase in flow rate,Reynolds number, nanoparticle concentration and nanofluid temperature. Finally, the new correlations were proposed for predicting the Nusselt number of the nanofluids, especially. Employing particles of nanometer dimension suspended in solution as nanofluid shows considerable increase in the nanofluid thermal conductivity and heat transfer coefficient which result in increasing heat transfer and decreasing operational cost

Stroke in SARS-CoV-2 Infection: A Pictorial Overview of the Pathoetiology

Since the early days of the pandemic, there have been several reports of cerebrovascular complications during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Numerous studies proposed a role for SARS-CoV-2 in igniting stroke. In this review, we focused on the pathoetiology of stroke among the infected patients. We pictured the results of the SARS-CoV-2 invasion to the central nervous system (CNS) via neuronal and hematogenous routes, in addition to viral infection in peripheral tissues with extensive crosstalk with the CNS. SARS-CoV-2 infection results in pro-inflammatory cytokine and chemokine release and activation of the immune system, COVID-19-associated coagulopathy, endotheliitis and vasculitis, hypoxia, imbalance in the renin-angiotensin system, and cardiovascular complications that all may lead to the incidence of stroke. Critically ill patients, those with pre-existing comorbidities and patients taking certain medications, such as drugs with elevated risk for arrhythmia or thrombophilia, are more susceptible to a stroke after SARS-CoV-2 infection. By providing a pictorial narrative review, we illustrated these associations in detail to broaden the scope of our understanding of stroke in SARS-CoV-2-infected patients. We also discussed the role of antiplatelets and anticoagulants for stroke prevention and the need for a personalized approach among patients with SARS-CoV-2 infection. © Copyright © 2021 Aghayari Sheikh Neshin, Shahjouei, Koza, Friedenberg, Khodadadi, Sabra, Kobeissy, Ansari, Tsivgoulis, Li, Abedi, Wolk and Zand

SARS-CoV-2 and Stroke Characteristics: A Report from the Multinational COVID-19 Stroke Study Group

cited By 0BACKGROUND AND PURPOSE: Stroke is reported as a consequence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in several reports. However, data are sparse regarding the details of these patients in a multinational and large scale. METHODS: We conducted a multinational observational study on features of consecutive acute ischemic stroke, intracranial hemorrhage, and cerebral venous or sinus thrombosis among SARS-CoV-2-infected patients. We further investigated the risk of large vessel occlusion, stroke severity as measured by the National Institutes of Health Stroke Scale, and stroke subtype as measured by the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria among patients with acute ischemic stroke. In addition, we explored the neuroimaging findings, features of patients who were asymptomatic for SARS-CoV-2 infection at stroke onset, and the impact of geographic regions and countries' health expenditure on outcomes. RESULTS: Among the 136 tertiary centers of 32 countries who participated in this study, 71 centers from 17 countries had at least 1 eligible stroke patient. Of 432 patients included, 323 (74.8%) had acute ischemic stroke, 91 (21.1%) intracranial hemorrhage, and 18 (4.2%) cerebral venous or sinus thrombosis. A total of 183 (42.4%) patients were women, 104 (24.1%) patients were CONCLUSIONS: We observed a considerably higher rate of large vessel occlusions, a much lower rate of small vessel occlusion and lacunar infarction, and a considerable number of young stroke when compared with the population studies before the pandemic. The rate of mechanical thrombectomy was significantly lower in countries with lower health expenditures.Peer reviewe

Risk of stroke in hospitalized SARS-CoV-2 infected patients: A multinational study

Background: There is an increased attention to stroke following SARS-CoV-2. The goal of this study was to better depict the short-term risk of stroke and its associated factors among SARS-CoV-2 hospitalized patients. Methods: This multicentre, multinational observational study includes hospitalized SARS-CoV-2 patients from North and South America (United States, Canada, and Brazil), Europe (Greece, Italy, Finland, and Turkey), Asia (Lebanon, Iran, and India), and Oceania (New Zealand). The outcome was the risk of subsequent stroke. Centres were included by non-probability sampling. The counts and clinical characteristics including laboratory findings and imaging of the patients with and without a subsequent stroke were recorded according to a predefined protocol. Quality, risk of bias, and heterogeneity assessments were conducted according to ROBINS-E and Cochrane Q-test. The risk of subsequent stroke was estimated through meta-analyses with random effect models. Bivariate logistic regression was used to determine the parameters with predictive outcome value. The study was reported according to the STROBE, MOOSE, and EQUATOR guidelines. Findings: We received data from 26,175 hospitalized SARS-CoV-2 patients from 99 tertiary centres in 65 regions of 11 countries until May 1st, 2020. A total of 17,799 patients were included in meta-analyses. Among them, 156(0.9%) patients had a stroke—123(79%) ischaemic stroke, 27(17%) intracerebral/subarachnoid hemorrhage, and 6(4%) cerebral sinus thrombosis. Subsequent stroke risks calculated with meta-analyses, under low to moderate heterogeneity, were 0.5% among all centres in all countries, and 0.7% among countries with higher health expenditures. The need for mechanical ventilation (OR: 1.9, 95% CI:1.1–3.5, p = 0.03) and the presence of ischaemic heart disease (OR: 2.5, 95% CI:1.4–4.7, p = 0.006) were predictive of stroke. Interpretation: The results of this multi-national study on hospitalized patients with SARS-CoV-2 infection indicated an overall stroke risk of 0.5%(pooled risk: 0.9%). The need for mechanical ventilation and the history of ischaemic heart disease are the independent predictors of stroke among SARS-CoV-2 patients. Funding: None. © 2020 The Author