COVID-19 Lockdown Effects on Acute Stroke Care in Latin America
| Autor: | Juan Manuel Marquez-Romero, Hernán Bayona, Maia Gómez-Schneider, Pablo Bonardo, Fernando Góngora-Rivera, Pablo Amaya, Luis Diaz-Escobar, Alan Flores, Virginia A. Pujol-Lereis, Carolina León, Sheila C Ouriques-Martins, Sebastián F. Ameriso, Antonio Arauz, Pablo M. Lavados, Víctor Navia, Maria C Zurru, A. Luraschi, Carlos Abanto-Argomedo, Angélica Ruiz-Franco, Miguel A Barboza, Miguel Angel Vences |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty 2019-20 coronavirus outbreak Time Factors Latin Americans Coronavirus disease 2019 (COVID-19) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Treatment outcome Stroke mortality Time-to-Treatment Patient Admission Cause of Death Humans Medicine Hospital Mortality Practice Patterns Physicians' Stroke Acute stroke business.industry Endovascular Procedures Rehabilitation COVID-19 Length of Stay medicine.disease Patient Discharge Hospitalization Latin America Treatment Outcome Health Care Surveys Emergency medicine Female Surgery Neurology (clinical) Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Stroke and Cerebrovascular Diseases. 30:105985 |
| ISSN: | 1052-3057 |
| Popis: | COVID-19 pandemic has forced important changes in health care worldwide. Stroke care networks have been affected, especially during peak periods. We assessed the impact of the pandemic and lockdowns in stroke admissions and care in Latin America.A multinational study (7 countries, 18 centers) of patients admitted during the pandemic outbreak (March-June 2020). Comparisons were made with the same period in 2019. Numbers of cases, stroke etiology and severity, acute care and hospitalization outcomes were assessed.Most countries reported mild decreases in stroke admissions compared to the same period of 2019 (1187 vs. 1166, p = 0.03). Among stroke subtypes, there was a reduction in ischemic strokes (IS) admissions (78.3% vs. 73.9%, p = 0.01) compared with 2019, especially in IS with NIHSS 0-5 (50.1% vs. 44.9%, p = 0.03). A substantial increase in the proportion of stroke admissions beyond 48 h from symptoms onset was observed (13.8% vs. 20.5%, p 0.001). Nevertheless, no differences in total reperfusion treatment rates were observed, with similar door-to-needle, door-to-CT, and door-to-groin times in both periods. Other stroke outcomes, as all-type mortality during hospitalization (4.9% vs. 9.7%, p 0.001), length of stay (IQR 1-5 days vs. 0-9 days, p 0.001), and likelihood to be discharged home (91.6% vs. 83.0%, p 0.001), were compromised during COVID-19 lockdown period.In this Latin America survey, there was a mild decrease in admissions of IS during the COVID-19 lockdown period, with a significant delay in time to consultations and worse hospitalization outcomes. |
| Databáze: | OpenAIRE |
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