Author:
Benali Faysal,Stolze Lotte J.,Rozeman Anouk D.,Dinkelaar Wouter,Coutinho Jonathan M.,Emmer Bart J.,Gons Rob A. R.,Yo Lonneke F. S.,van Tuijl Julia H.,Boukrab Issam,van Dam-Nolen Dianne H. K.,van den Wijngaard Ido R.,Lycklama à Nijeholt Geert J.,de Laat Karlijn F.,van Dijk Lukas C.,den Hertog Heleen M.,Flach H. Zwenneke,Wermer Marieke J. H.,van Walderveen Marianne A. A.,Brouwers Paul J. A. M.,Bulut Tomas,Vermeer Sarah E.,Bernsen Marie Louise E.,Uyttenboogaart Maarten,Bokkers Reinoud P. H.,Boogaarts Jeroen D.,de Leeuw Frank-Erik,van der Worp H. Bart,van der Schaaf Irene C.,Schonewille Wouter J.,Vos Jan A.,Remmers Michel J. M.,Imani Farshad,Dippel Diederik W. J.,van Zwam Wim H.,Nederkoorn Paul J.,van Oostenbrugge Robert J.
Abstract
Abstract
Introduction
We investigated the impact of the Corona Virus Disease 2019 (COVID-19) pandemic and the resulting lockdown on reperfusion treatments and door-to-treatment times during the first surge in Dutch comprehensive stroke centers. Furthermore, we studied the association between COVID-19-status and treatment times.
Methods
We included all patients receiving reperfusion treatment in 17 Dutch stroke centers from May 11th, 2017, until May 11th, 2020. We collected baseline characteristics, National Institutes of Health Stroke Scale (NIHSS) at admission, onset-to-door time (ODT), door-to-needle time (DNT), door-to-groin time (DGT) and COVID-19-status at admission. Parameters during the lockdown (March 15th, 2020 until May 11th, 2020) were compared with those in the same period in 2019, and between groups stratified by COVID-19-status. We used nationwide data and extrapolated our findings to the increasing trend of EVT numbers since May 2017.
Results
A decline of 14% was seen in reperfusion treatments during lockdown, with a decline in both IVT and EVT delivery. DGT increased by 12 min (50 to 62 min, p-value of < 0.001). Furthermore, median NIHSS-scores were higher in COVID-19 - suspected or positive patients (7 to 11, p-value of 0.004), door-to-treatment times did not differ significantly when stratified for COVID-19-status.
Conclusions
During the first surge of the COVID-19 pandemic, a decline in acute reperfusion treatments and a delay in DGT was seen, which indicates a target for attention. It also appeared that COVID-19-positive or -suspected patients had more severe neurologic symptoms, whereas their EVT-workflow was not affected.
Publisher
Springer Science and Business Media LLC
Subject
Neurology (clinical),General Medicine
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