Acute Stroke Management During the COVID-19 Pandemic-Reference-Cited by-同舟云学术

Acute Stroke Management During the COVID-19 Pandemic

Published:2020-08 Issue:8 Volume:51 Page:2593-2596
ISSN:0039-2499
Container-title:Stroke
language:en
Short-container-title:Stroke

Author:

Hajdu Steven D.¹^ORCID,Pittet Valerie²,Puccinelli Francesco¹,Ben Hassen Wagih³,Ben Maacha Malek⁴,Blanc Raphaël⁴,Bracco Sandra⁵,Broocks Gabriel⁶,Bartolini Bruno¹,Casseri Tommaso⁵,Clarençon Frederic⁷,Naggara Olivier³,Eugène François⁸,Ferré Jean-Christophe⁸,Guédon Alexis⁹,Houdart Emmanuel⁹,Krings Timo¹⁰,Lehmann Pierre¹¹,Limbucci Nicola¹²,Machi Paolo¹³,Macho Juan¹⁴,Mandruzzato Nicolo¹³,Nappini Sergio¹²,Nawka Marie Teresa,Nicholson Patrick⁶¹⁰,Marto João Pedro¹⁵,Pereira Vitor¹⁰,Correia Manuel A.¹⁶,Pinho-e-Melo Teresa¹⁶,Nuno Ramos João¹⁵,Raz Eytan¹⁷,Ferreira Patrícia¹⁸,Reis João¹⁸,Shapiro Maksim¹⁷,Shotar Eimad⁷,van Horn Noel⁶,Piotin Michel⁴,Saliou Guillaume¹

Affiliation:

1. Department of Interventional and Diagnostic Radiology, Lausanne University Hospital, Switzerland (S.D.H., F.P., B.B., G.S.).

2. Center for Primary Care and Public Health, University of Lausanne, Switzerland (V.P.).

3. Department of Neuroradiology, Sainte Anne Hospital, Paris, France (W.B.H., O.N.).

4. Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France (M.B.M., R.B., M.P.).

5. Unit of Neuroimaging and Neurointervention, University Hospital of Siena, Italy (S.B., T.C.).

6. Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, Hamburg, Germany (G.B., M.T.N., N.v.H.).

7. Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France (F.C., E.S.).

8. Department of Neuroradiology, Centre Hospitalier Universitaire de Rennes, Rennes, France (F.E., J.-C.F.).

9. Department of Neuroradiology, Lariboisière Hospital, Paris, France (A.G., E.H.).

10. Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, Canada (T.K., P.N., V.P.).

11. Department of Neuroradiology, Marseille Hospital, France (P.L.).

12. Department of Interventional Neuroradiology, Careggi University Hospital, Florence, Italy (N.L., S.N.).

13. Service of diagnostic and interventional neuroradiology, Geneva University Hospital, Switzerland (P.M., N.M.).

14. Radiology Department, Hospital Clinic, Barcelona, Spain (J.M.).

15. Departments of Neurology and Neuroradiology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal (J.P.M., J.N.R.).

16. Departments of Neurology and Neuroradiology, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal (M.A.C., T.P.-e.-M.).

17. NYU Langone Health, New York (E.R., M.S.).

18. Stroke Unit and Department of Neuroradiology, Hospital São José, Centro Hospitalar Lisboa Central, Lisbon, Portugal (P.F., J.R.).

Abstract

During the coronavirus disease 2019 (COVID-19) pandemic, the World Health Organization recommended measures to mitigate the outbreak such as social distancing and confinement. Since these measures have been put in place, anecdotal reports describe a decrease in the number of endovascular therapy (EVT) treatments for acute ischemic stroke due to large vessel occlusion. The purpose of our study was to determine the effect on EVT for patients with acute ischemic stroke during the COVID-19 confinement. In this retrospective, observational study, data were collected from November 1, 2019, to April 15, 2020, at 17 stroke centers in countries where confinement measures have been in place since March 2020 for the COVID-19 pandemic (Switzerland, Italy, France, Spain, Portugal, Germany, Canada, and United States). This study included 1600 patients treated by EVT for acute ischemic stroke. Date of EVT and symptom onset-to-groin puncture time were collected. Mean number of EVTs performed per hospital per 2-week interval and mean stroke onset-to-groin puncture time were calculated before confinement measures and after confinement measures. Distributions (non-normal) between the 2 groups (before COVID-19 confinement versus after COVID-19 confinement) were compared using 2-sample Wilcoxon rank-sum test. The results show a significant decrease in mean number of EVTs performed per hospital per 2-week interval between before COVID-19 confinement (9.0 [95% CI, 7.8–10.1]) and after COVID-19 confinement (6.1 [95% CI, 4.5–7.7]), ( P <0.001). In addition, there is a significant increase in mean stroke onset-to-groin puncture time ( P <0.001), between before COVID-19 confinement (300.3 minutes [95% CI, 285.3–315.4]) and after COVID-19 confinement (354.5 minutes [95% CI, 316.2–392.7]). Our preliminary analysis indicates a 32% reduction in EVT procedures and an estimated 54-minute increase in symptom onset-to-groin puncture time after confinement measures for COVID-19 pandemic were put into place.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

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