Infarction Growth and Penumbral Consumption After Reperfusion in COVID Vaccine-Naïve Patients

American Roentgen Ray Society

Leesburg, VA, May 18, 2023—According to an accepted manuscript published in ARRS' own American Journal of Roentgenology (AJR), SARS-CoV-2 infection may promote continued infarction progression, despite angiographic reperfusion, in vaccine-naïve patients with large-vessel occlusion acute ischemic stroke (AIS).

"The findings carry potential implications for prognostication, treatment selection, and surveillance for infarction growth among revascularized patients in future waves of infection by novel viral strains," wrote first author Seena Dehkharghani, MD, director of stroke and cerebrovascular imaging at New York University Langone Medical Center.

This AJR accepted manuscript compared 100 consecutively presenting patients with COVID-19 and AIS between March 2020 and April 2021 with a contemporaneous cohort of 282 patients with AIS who did not have COVID-19. Reperfusion classes were dichotomized into positive (extended thrombolysis in cerebral ischemia [eTICI] score = 2c–3) and negative (eTICI score

Ultimately, in this case-control study of vaccine-naïve patients with and without COVID-19 with infarct growth after endovascular reperfusion during acute ischemic stroke, COVID-19 was a significant predictor for absolute infarct growth of 15 cm3 or more (OR, 5.1 [95% CI, 1.0–25.95]; p = .05).

"These findings support the potentially aggressive clinical course of cerebrovascular events in patients with COVID-19, suggesting greater infarction growth and ongoing consumption of at-risk tissues, even following angiographic reperfusion," Dehkharghani et al. added.


North America's first radiological society, the American Roentgen Ray Society (ARRS) remains dedicated to the advancement of medicine through the profession of medical imaging and its allied sciences. An international forum for progress in radiology since the discovery of the x-ray, ARRS maintains its mission of improving health through a community committed to advancing knowledge and skills with the world's longest continuously published radiology journal—American Journal of Roentgenology—the ARRS Annual Meeting, InPractice magazine, topical symposia, myriad multimedia educational materials, as well as awarding scholarships via The Roentgen Fund®.

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