Effect of COVID-19 on Emergent Stroke Care

Hsiao, Jessica; Sayles, Emily; Antzoulatos, Eleni; Stanton, Robert J.; Sucharew, Heidi; Broderick, Joseph P.; Demel, Stacie L; Flaherty, Matthew L.; Grossman, Aaron W.; Kircher, Charles; Kreitzer, Natalie; Peariso, Katrina; Prestigiacomo, Charles J.; Shirani, Peyman; Walsh, Kyle B; Lampton, Holly; Adeoye, Opeolu; Khatri, Pooja

doi:10.1161/strokeaha.120.030499

Cited by 46 publications

(52 citation statements)

References 4 publications

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“…In line with previous studies, the volume of IVT markedly decreased during the COVID-19 period [3][4][5][7][8][9][10]. The main factor for limiting the use of IVT among patients treated with MT was time delay.…”

Section: Discussionsupporting

confidence: 88%

“…The effect of the COVID-19 pandemic on stroke care is still debated. Although some studies have reported an impact of the pandemic on acute ischemic stroke (AIS) care in terms of admissions and reperfusion therapy volumes along with longer treatment times and a decrease in the use of stroke imaging compared with control periods in 2019, other reports have not detected significant effects on revascularization procedures [3][4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Effect of the COVID-19 pandemic on acute stroke reperfusion therapy: data from the Lyon Stroke Center Network

et al. 2020

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Background The coronavirus disease 2019 (COVID-19) pandemic would have particularly affected acute stroke care. However, its impact is clearly inherent to the local stroke network conditions. We aimed to assess the impact of COVID-19 pandemic on acute stroke care in the Lyon comprehensive stroke center during this period. Methods We conducted a prospective data collection of patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT) during the COVID-19 period (from 29/02/2020 to 10/05/2020) and a control period (from 29/02/2019 to 10/05/2019). The volume of reperfusion therapies and pre and intra-hospital delays were compared during both periods. Results A total of 208 patients were included. The volume of IVT significantly decreased during the COVID-period [55 (54.5%) vs 74 (69.2%); p = 0.03]. The volume of MT remains stable over the two periods [72 (71.3%) vs 65 (60.8%); p = 0.14], but the door-to-groin puncture time increased in patients transferred for MT (237 [187-339] vs 210 [163-260]; p < 0.01). The daily number of Emergency Medical Dispatch calls considerably increased (1502 [1133-2238] vs 1023 [960-1410]; p < 0.01). Conclusions Our study showed a decrease in the volume of IVT, whereas the volume of MT remained stable although intrahospital delays increased for transferred patients during the COVID-19 pandemic. These results contrast in part with the national surveys and suggest that the impact of the pandemic may depend on local stroke care networks.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Effect of the COVID-19 pandemic on acute stroke reperfusion therapy: data from the Lyon Stroke Center Network

et al. 2020

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“…Nevertheless, we failed to observe our expected yearly growth in the number of reperfusion procedures. A similar observation was made by Hsiao, et al [8]. The magnitude of the COVID-19 pandemics was also lower in our region compared to other French regions as the Grand-Est, and could have modi ed its impact of the COVID-19 on stroke care as reported in Germany [10].…”

Section: Discussionsupporting

confidence: 90%

“…In line with previous studies, the volume of IVT markedly decreased during the COVID-19 period [3][4][5][7][8][9][10]. The volume of MT remained stable between the 2 periods while previous studies have reported con icting results [3][4][5][8][9][10].…”

Section: Discussionsupporting

confidence: 89%

“…The effect of the COVID-19 pandemic on stroke care is still debated. Although some studies have reported an impact of the pandemic on acute ischemic stroke (AIS) care in terms of admissions and reperfusion therapies volumes along with longer treatment times and a decrease in the use of stroke imaging compared with control periods in 2019, other reports have not detected signi cant effects on revascularization procedures [3][4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of the COVID-19 pandemic on acute stroke reperfusion therapy: data from the Lyon Stroke Center Network

Plumereau

Cho

Buisson

et al. 2020

Preprint

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BackgroundThe coronavirus disease 2019 (COVID-19) pandemic would have particularly affected acute stroke care. However, its impact is clearly inherent to the local stroke network conditions. We aimed to assess the impact of COVID-19 pandemic on acute stroke care in the Lyon comprehensive stroke center during this period.MethodsWe conducted a prospective data collection of patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT) during the COVID-19 period (from 29/02/2020 to 10/05/2020) and a control period (from 29/02/2019 to 10/05/2019). The volume of reperfusion therapies and pre and intra-hospital delays were compared during both periods.ResultsA total of 208 patients were included. The volume of IVT significantly decreased during the COVID-period (55 (54.5%) vs 74 (69.2%); p=0.03) and was mainly due to time delay among patients treated with MT. The volume of MT remains stable over the two periods (72 (71.3%) vs 65 (60.8%); p=0.14) but the door-to-groin puncture time increased in patients transferred for MT (237 [187-339] vs 210 [163-260]; p<0.01). The daily number of Emergency Medical Dispatch calls considerably increased (1502 [1133-2238] vs 1023 [960-1410]; p<0.01).ConclusionsOur study showed a decrease of the volume of IVT, whereas the volume of MT remained stable although intra-hospital delays increased for transferred patients during the COVID-19 pandemic. These results contrast in part with the national surveys and suggest that the impact of the pandemic may depend on local stroke care networks.

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Hospital admissions of acute cerebrovascular diseases during and after the first wave of the COVID-19 pandemic: a state-wide experience from Austria

et al. 2021

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We investigated hospital admission rates for the entire spectrum of acute cerebrovascular diseases and of recanalization treatments for ischaemic stroke (IS) in the Austrian federal state of Styria during and also after the first coronavirus disease 2019 (COVID-19) wave. We retrospectively identified all patients with transient ischaemic attack (TIA), IS and non-traumatic intracranial haemorrhage (ICH; including intracerebral, subdural and subarachnoid bleeding types) admitted to one of the 11 public hospitals in Styria (covering > 95% of inhospital cerebrovascular events in this region). Information was extracted from the electronic medical documentation network connecting all public Styrian hospitals. We analysed two periods of interest: (1) three peak months of the first COVID-19 wave (March–May 2020), and (2) three recovery months thereafter (June–August 2020), compared to respective periods 4 years prior (2016–2019) using Poisson regression. In the three peak months of the first COVID-19 wave, there was an overall decline in hospital admissions for acute cerebrovascular diseases (RR = 0.83, 95% CI 0.78–0.89, p < 0.001), which was significant for TIA (RR = 0.61, 95% CI 0.52–0.72, p < 0.001) and ICH (0.78, 95% CI 0.67–0.91, p = 0.02), but not for IS (RR = 0.93, 95% CI 0.85–1, p = 0.08). Thrombolysis and thrombectomy numbers were not different compared to respective months 4 years prior. In the recovery period after the first COVID-19 wave, TIA (RR = 0.82, 95% CI 0.71–0.96, p = 0.011) and ICH (RR = 0.86, 95% CI 0.74–0.99, p = 0.045) hospitalizations remained lower, while the frequency of IS and recanalization treatments was unchanged. In this state-wide analysis covering all types of acute cerebrovascular diseases, hospital admissions for TIA and ICH were reduced during and also after the first wave of the COVID-19 pandemic, but hospitalizations and recanalization treatments for IS were not affected in these two periods.

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Effect of COVID-19 on Emergent Stroke Care

Cited by 46 publications

References 4 publications

Effect of the COVID-19 pandemic on acute stroke reperfusion therapy: data from the Lyon Stroke Center Network

Effect of the COVID-19 pandemic on acute stroke reperfusion therapy: data from the Lyon Stroke Center Network

Effect of the COVID-19 pandemic on acute stroke reperfusion therapy: data from the Lyon Stroke Center Network

Hospital admissions of acute cerebrovascular diseases during and after the first wave of the COVID-19 pandemic: a state-wide experience from Austria

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