Impact of the COVID-19 Pandemic on Acute Ischemic Stroke Presentation, Treatment, and Outcomes
| Autor: | Pina C. Sanelli, Artem Boltyenkov, Rohan Arora, Gabriela Martinez, Timothy G White, Jason J Wang, Henry H. Woo, Jeffrey M. Katz, Michele Gribko |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Article Subject Coronavirus disease 2019 (COVID-19) business.industry MEDLINE Stroke volume 030204 cardiovascular system & hematology medicine.disease Tissue plasminogen activator 03 medical and health sciences 0302 clinical medicine Emergency medicine Pandemic medicine Neurology. Diseases of the nervous system Neurology (clinical) Presentation (obstetrics) RC346-429 business Stroke Acute ischemic stroke 030217 neurology & neurosurgery Research Article medicine.drug |
| Zdroj: | Stroke Research and Treatment, Vol 2021 (2021) Stroke Research and Treatment |
| ISSN: | 2042-0056 2090-8105 |
| Popis: | Introduction. The World Health Organization declared COVID-19 a global pandemic last year. While a clear impact of COVID-19 on the declining stroke volume has been reported, its overall impact on stroke presentation and clinical outcomes has not been established. The purpose of this study was to assess the impact of COVID-19 on acute ischemic stroke volume, presentation, treatment, and outcomes at comprehensive stroke centers. Methods. A retrospective review of patients with a discharge diagnosis of acute ischemic stroke from the Get With The Guidelines database was performed from January 1, 2019, to July 1, 2020. The following time periods were defined: Pre-COVID (January/February), Peak-COVID (March/April), and Post-COVID (May/June). Bivariate analyses were performed comparing the 2020 and 2019 time periods to determine differences in stroke volume, presentation, treatment, and outcomes. Results. Stroke volumes were significantly lower during the Peak-COVID period in 2020 compared to that in 2019, with an absolute decline of 49.5% ( P < 0.001 ). Patients were more likely to present after 24 hours from last known well during the 2020 Peak-COVID period ( P = 0.03 ). However, there was not a significant difference in the rate of treatment with either the tissue plasminogen activator (tPA) or mechanical thrombectomy during the Peak-COVID period. Interestingly, relative treatment rates increased during the 2020 Post-COVID period to 11.4% ( P = 0.01 ). Conclusions. The overall ischemic stroke volume decreased during the pandemic, and patients had a tendency to present later, beyond eligible treatment windows. However, rates of treatment, patient demographics, and stroke outcomes did not significantly change when compared to the prior year. |
| Databáze: | OpenAIRE |
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