Background: Endothelial dysfunction plays a critical role in ischemic stroke. The Endothelial Activation and Stress Index (EASIX), calculated from creatinine, lactate dehydrogenase (LDH), and platelet levels, reflects endothelial injury. This study aimed to investigate the relationship between EASIX and 90-day mortality in patients with posterior circulation ischemic stroke (PCIS) treated with mechanical thrombectomy. Methods: Fifty-eight patients with acute ischemic stroke who underwent mechanical thrombectomy (MT) or MT combined with intravenous thrombolysis (intravenous tissue plasminogen activator (tPA)) for posterior circulation ischemic stroke (PCIS) were included. EASIX was calculated using 24 h laboratory values of creatinine, LDH, and platelets. Its association with 90-day mortality, length of hospital stay, intubation, and parenchymal hemorrhage was analyzed. Results: In patients receiving reperfusion therapy, the Endothelial Activation and Stress Index (EASIX) showed modest ability to predict 90-day mortality (AUC = 0.583, 95% CI 0.428–0.739, p = 0.295). Higher EASIX values were linked to a 6.58-fold increase in mortality risk. Patients with elevated EASIX were generally older, had more frequent hyperlipidemia, had higher 24 h National Institutes of Health Stroke Scale (NIHSS) scores, had greater need for intubation, and had higher in-hospital mortality. Conclusions: EASIX is a simple, inexpensive, and non-invasive marker that may reflect endothelial dysfunction and help predict mortality in PCIS patients undergoing reperfusion therapy. Higher EASIX values are associated with poorer prognosis. Early identification of high-risk patients may support secondary prevention strategies.

Background: Coronavirus disease 2019 (COVID-19) is a disease that affects many organs, especially the lung, and may lead to multiorgan failure. Studies describing neurological dysfunctions involving the central and peripheral nervous systems have emerged. In our study, we aimed to evaluate the neurological signs and symptoms in hospitalized patients with COVID-19. Methods: The data of 290 patients admitted to our center (ward and intensive care unit) who received a diagnosis of COVID-19 were analyzed retrospectively. Patients’ demographic, clinical and laboratory data, and their neurological diseases, symptoms, and complications were compared. Results: Male sex, heart disease, chronic obstructive pulmonary disease and having a history of neurological disease were associated with increased mortality in patients with COVID-19. Seizures and altered consciousness were also found to be more common in patients who died. In addition, lower platelet counts (P=0.001), higher C-reactive protein levels (P<0.001) and higher D-dimer levels (P=0.003) were associated with increased risk of mortality. Conclusions: We believe that close monitoring of any possible neurological manifestations is mandatory in hospitalized patients at the onset of COVID-19 and during disease progression. Clinical findings such as neurological symptoms and acute phase reactants are important in the follow-up and treatment of the disease.

Background: We aimed to determine factors affecting mortality and survival after Percutaneous endoscopic gastrostomy (PEG) in patients who were hospitalized in the neurology intensive care unit during the coronavirus disease-2019 (COVID-19) pandemic Materials and Methods: The clinical and demographic data of 29 patients aged 18 years and older who received PEG tube insertion during hospitalization in the Neurology Intensive Care Unit of XXX Hospital, Turkey, between February 2020 and May 2021 were examined retrospectively. Patients’ demographics, clinical characteristics, and survival status were recorded. Results: We included 29 patients (16 females and 13 males) into our study. Median age was 71 (33–89) years among survivors and 75.5 (48–90) years among those who died. The groups were similar with respect to age (p = 0.119) and sex (p = 0.806). Mortality rate after PEG insertion was 66%. Mean overall survival after PEG tube insertion was 129.49 days (95% CI: 91.21–167.78). Cox regression revealed that having multiple comorbidities increased the likelihood of mortality by 2.822-fold (95% CI: 1.001–7.968, p = 0.049). Conclusions: These findings show that having multiple comorbidities was the most important factor associated with mortality among PEG recipients who were admitted to the Neurology Intensive Care Unit during the COVID-19 pandemic. Since multiple comorbidities cause shorter survival, it appears that the decision to insert PEG tubes must be made extremely cautiously among these patients. However, more comprehensive studies should be conducted to clarify the effect of COVID-19 on mortality rates and survival time after PEG.

Objective To investigate whether the COVID-19 pandemic had an effect on the emergency department admission complaints of patients with neurological symptoms. Methods A total of 976 patients admitted to the emergency department of our hospital and had undergone neurology consultation during a 6-month period were evaluated. The reasons for consultation, the number of patients consulted, hospitalization counts, and imaging studies for neurological assessment including computerized tomography (CT) and magnetic resonance imaging (MRI), were recorded and compared. Results Compared to the pre-pandemic period, there were significant decreases in the number of neurological consultations requested by the emergency department (overall and related to stroke, seizure and other reasons) and the number of patients hospitalized in the neurology department. We also found that the number of orders for cranial CT and MRI images during the pandemic period had decreased significantly. Conclusion Restrictions, social isolation measures and patients’ reluctance to apply to hospitals to avoid contact with possibly infected people may have led to a decrease in the number of patients with neurological symptoms admitted to the emergency department and the number of hospitalized patients.