Supplementary Material for: Characteristics, Management, and Case-Fatality of Patients Hospitalized for Stroke with a Diagnosis of COVID-19 in France

Introduction: COVID-19 was found to be associated with an increased risk of stroke. This study aimed to compare characteristics, management, and outcomes of hospitalized stroke patients with or without a hospital diagnosis of CO­VID-19 at a nationwide scale. Methods: This is a cross-sectional study on all French hospitals covering the entire French population using the French national hospital discharge databases (Programme de Médicalisation des Systèmes d’Information, included in the Système National des Données de Santé). All patients hospitalized for stroke between 1 January and 14 June 2020 in France were selected. A diagnosis of COVID-19 was searched for during the index hospitalization for stroke or in a prior hospitalization that had occurred after 1 January 2020. Results: Among the 56,195 patients hospitalized for stroke, 800 (1.4%) had a concomitant COVID-19 diagnosis. Inhospital case-fatality rates were higher in stroke patients with COVID-19, particularly for patients with a primary diagnosis of COVID-19 (33.2%), as compared to patients hospitalized for stroke without CO­VID-19 diagnosis (14.1%). Similar findings were observed for 3-month case-fatality rates adjusted for age and sex that reached 41.7% in patients hospitalized for stroke with a concomitant primary diagnosis of COVID-19 versus 20.0% in strokes without COVID-19. Conclusion: Patients hospitalized for stroke with a concomitant COVID-19 diagnosis had a higher inhospital and 3 months case-fatality rates compared to patients hospitalized for stroke without a COVID-19 diagnosis. Further research is needed to better understand the excess of mortality related to these cases.

### 引言
现有研究表明，新型冠状病毒肺炎（COVID-19）与脑卒中发病风险升高存在关联。本研究旨在全国范围内对比伴与不伴院内新型冠状病毒肺炎诊断的住院脑卒中患者的临床特征、诊疗方案及预后结局。

### 研究方法
本研究为横断面研究，依托覆盖全法人群的法国国家医院出院数据库开展，该数据库隶属于法国国家健康数据系统（Système National des Données de Santé, SNDS），全称为医疗信息系统信息化项目（Programme de Médicalisation des Systèmes d’Information, PMSI）。研究纳入2020年1月1日至6月14日期间在法国因脑卒中住院的所有患者，并对患者本次脑卒中住院期间或2020年1月1日后既往住院期间的新型冠状病毒肺炎诊断情况进行了检索。

### 研究结果
本研究共纳入56195例脑卒中住院患者，其中800例（1.4%）伴新型冠状病毒肺炎诊断。与未伴新型冠状病毒肺炎诊断的脑卒中住院患者（14.1%）相比，伴新型冠状病毒肺炎的脑卒中住院患者院内病死率更高，其中以新型冠状病毒肺炎为首要诊断的患者（33.2%）尤为显著。经年龄与性别校正后的3个月病死率也呈现相似趋势：伴原发性新型冠状病毒肺炎诊断的脑卒中住院患者3个月病死率达41.7%，而未伴新型冠状病毒肺炎的脑卒中患者仅为20.0%。

### 研究结论
伴新型冠状病毒肺炎诊断的脑卒中住院患者，其院内病死率及3个月病死率均显著高于未伴新型冠状病毒肺炎诊断的脑卒中住院患者。未来仍需开展进一步研究，以明确此类患者额外死亡风险的相关机制。