Changes in Stroke Hospital Care During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis-Reference-Cited by-同舟云学术

Changes in Stroke Hospital Care During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Published:2021-11 Issue:11 Volume:52 Page:3651-3660
ISSN:0039-2499
Container-title:Stroke
language:en
Short-container-title:Stroke

Author:

Katsanos Aristeidis H.¹²^ORCID,Palaiodimou Lina²,Zand Ramin³,Yaghi Shadi⁴,Kamel Hooman⁵,Navi Babak B.⁵,Turc Guillaume⁶⁷⁸⁹,Benetou Vassiliki¹⁰,Sharma Vijay K.¹¹,Mavridis Dimitris¹²¹³^ORCID,Shahjouei Shima³^ORCID,Catanese Luciana¹,Shoamanesh Ashkan¹,Vadikolias Konstantinos¹⁴,Tsioufis Konstantinos¹⁵^ORCID,Lagiou Pagona¹⁰¹⁶,Sfikakis Petros P.¹⁷,Alexandrov Andrei V.¹⁸^ORCID,Tsiodras Sotirios¹⁹²⁰^ORCID,Tsivgoulis Georgios²¹⁸

Affiliation:

1. Division of Neurology, McMaster University/Population Health Research Institute, Hamilton, Canada (A.H.K., L.C., A.S.).

2. Second Department of Neurology, “Attikon” Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece (A.H.K., L.P., G. Tsivgoulis.).

3. Neurosience Institute, Geisinger Health System, Danville, Pennsylvania (R.Z., S.S.).

4. Department of Neurology, NYU Langone Health, NY (S.Y.).

5. Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, NY (H.K., B.B.N.).

6. Department of Neurology, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, France (G. Turc).

7. Université de Paris, France (G. Turc).

8. INSERM U1266, Paris, France (G. Turc).

9. FHU Neurovasc, Paris, France (G. Turc).

10. Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece (V.B., P.L.).

11. Division of Neurology, Department of Medicine, National University Hospital, Singapore and School of Medicine, National University of Singapore (V.K.S.).

12. Department of Primary Education, University of Ioannina, Greece (D.M.).

13. Université Paris Descartes, Faculté de Médecine, France (D.M.).

14. Department of Neurology, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece (K.V.).

15. First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Greece (K.T.).

16. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (P.L.).

17. Joint Rheumatology Program, First Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Greece (P.P.S.).

18. Department of Neurology, University of Tennessee Health Science Center, Memphis (A.V.A., G. Tsivgoulis).

19. Fourth Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Greece (S.T.).

20. National Public Health Organization of Greece, Athens (S.T.).

Abstract

Background and Purpose: We systematically evaluated the impact of the coronavirus 2019 (COVID-19) pandemic on stroke care across the world. Methods: Observational studies comparing characteristics, acute treatment delivery, or hospitalization outcomes between patients with stroke admitted during the COVID-19 pandemic and those admitted before the pandemic were identified by Medline, Scopus, and Embase databases search. Random-effects meta-analyses were conducted for all outcomes. Results: We identified 46 studies including 129 491 patients. Patients admitted with stroke during the COVID-19 pandemic were found to be younger (mean difference, −1.19 [95% CI, −2.05 to −0.32]; I 2 =70%) and more frequently male (odds ratio, 1.11 [95% CI, 1.01–1.22]; I 2 =54%) compared with patients admitted with stroke in the prepandemic era. Patients admitted with stroke during the COVID-19 pandemic, also, had higher baseline National Institutes of Health Stroke Scale scores (mean difference, 0.55 [95% CI, 0.12–0.98]; I 2 =90%), higher probability for large vessel occlusion presence (odds ratio, 1.63 [95% CI, 1.07–2.48]; I 2 =49%) and higher risk for in-hospital mortality (odds ratio, 1.26 [95% CI, 1.05–1.52]; I 2 =55%). Patients with acute ischemic stroke admitted during the COVID-19 pandemic had higher probability of receiving endovascular thrombectomy treatment (odds ratio, 1.24 [95% CI, 1.05–1.47]; I 2 =40%). No difference in the rates of intravenous thrombolysis administration or difference in time metrics regarding onset to treatment time for intravenous thrombolysis and onset to groin puncture time for endovascular thrombectomy were detected. Conclusions: The present systematic review and meta-analysis indicates an increased prevalence of younger patients, more severe strokes attributed to large vessel occlusion, and higher endovascular treatment rates during the COVID-19 pandemic. Patients admitted with stroke during the COVID-19 pandemic had higher in-hospital mortality. These findings need to be interpreted with caution in view of discrepant reports and heterogeneity being present across studies.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialised Nursing,Cardiology and Cardiovascular Medicine,Clinical Neurology

Link

https://www.ahajournals.org/doi/pdf/10.1161/STROKEAHA.121.034601

Reference86 articles.

1. Ischemic Stroke Epidemiology During the COVID-19 Pandemic

2. Neurological manifestations and implications of COVID-19 pandemic.;Tsivgoulis G;Ther Adv Neurol Disord,2020

3. The Curious Case of the Missing Strokes During the COVID-19 Pandemic

4. Acute stroke treatment during coronavirus disease 2019 pandemic.;Baracchini C;Curr Opin Neurol,2021

5. Maintaining stroke care in Europe during the COVID-19 pandemic: Results from an international survey of stroke professionals and practice recommendations from the European Stroke Organisation.;Aguiar de Sousa D;Eur Stroke J,2020

Cited by 23 articles. 订阅此论文施引文献订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献

1. Patient factors associated with treatment time for stroke before and after the onset of COVID-19;Geriatric Nursing;2024-03

2. The evolution of acute stroke care in Germany from 2019 to 2021: analysis of nation-wide administrative datasets;Neurological Research and Practice;2024-01-11

3. The role of imaging in detecting and monitoring COVID-19 complications in the Intensive Care Unit (ICU) setting;Anesthesiology and Perioperative Science;2024-01-02

4. Assessment of post-COVID-19 fatigue among female survivors 2 years after hospital discharge: a nested case–control study;BMC Public Health;2023-12-07

5. Changes in stroke and TIA admissions during the COVID-19 pandemic: A meta-analysis;European Stroke Journal;2023-09-29