A Chilean Experience of Telestroke in a COVID-19 Pandemic Year

Abstract

<b><i>Background and Purpose:</i></b> Telemedicine for stroke patients’ care (telestroke [TS]) has grown notably in recent decades and may offer advantages during health crisis. Hospital admissions related to stroke have decreased globally during the COVID-19 pandemic, but scarce information is available regarding the effect of COVID-19 in TS. Using a population-based TS registry, we investigated the impact of the first year of the COVID-19 pandemic throughout our TS network in Santiago, Chile. <b><i>Methods:</i></b> Stroke codes evaluated after the onset of COVID-19 restrictions in Chile (defined as March 15, 2020) were compared with those evaluated in 2019. We analyzed differences between number of stroke codes, thrombolysis rate, stroke severity, and time from the stroke onset to hospital admission. <b><i>Results:</i></b> We observed that the number of stroke codes and the number of patients undergoing reperfusion therapy did not change significantly (<i>p</i> = 0.669 and 0.415, respectively). No differences were found with respect to the median time from the stroke onset to admission (<i>p</i> = 0.581) or in National Institutes of Health Stroke Scale (NIHSS) scores (<i>p</i> = 0.055). The decision-making-to-needle time was significantly shorter in the COVID-19 period (median 5 min [IQR 3–8], <i>p</i> < 0.016), but no significant changes were found at the other times. <b><i>Conclusions:</i></b> This study demonstrates the potential of adapting TS to extreme situations such as the COVID-19 pandemic, as well as the importance of establishing networks that facilitate patient access to quality treatments.

Disruption to diabetes and hypertension care during the COVID-19 pandemic in Latin America and the Caribbean and mitigation approaches: A Scoping Review

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Telestroke’s Role Through the COVID-19 Pandemic and Beyond

“…One pandemic-era report from the Spanish region of Catalonia showed that their 14 TS centers experienced more than 30% reduction in TS code activations and > 50% decrease in thrombolysis treatment in the first 7 weeks following the declaration of the pandemic compared to the 7-week period pre-pandemic [53]. However, reports from western China and Chile each showed that their TS systems and networks did not face any significant reduction in stroke codes or reperfusion therapy in the first year of the pandemic compared to the year before [55,56].…”