Abstract
BackgroundThe coronavirus disease 2019 (COVID-19) pandemic would have particularly affected acute stroke care. However, its impact is clearly inherent to the local stroke network conditions. We aimed to assess the impact of COVID-19 pandemic on acute stroke care in the Lyon comprehensive stroke center during this period.MethodsWe conducted a prospective data collection of patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT) during the COVID-19 period (from 29/02/2020 to 10/05/2020) and a control period (from 29/02/2019 to 10/05/2019). The volume of reperfusion therapies and pre and intra-hospital delays were compared during both periods.ResultsA total of 208 patients were included. The volume of IVT significantly decreased during the COVID-period [55 (54.5%) vs 74 (69.2%); p = 0.03]. The volume of MT remains stable over the two periods [72 (71.3%) vs 65 (60.8%); p = 0.14], but the door-to-groin puncture time increased in patients transferred for MT (237 [187–339] vs 210 [163–260]; p < 0.01). The daily number of Emergency Medical Dispatch calls considerably increased (1502 [1133–2238] vs 1023 [960–1410]; p < 0.01).ConclusionsOur study showed a decrease in the volume of IVT, whereas the volume of MT remained stable although intra-hospital delays increased for transferred patients during the COVID-19 pandemic. These results contrast in part with the national surveys and suggest that the impact of the pandemic may depend on local stroke care networks.
Highlights
The healthcare system has been disrupted during the coronavirus disease 2019 (COVID-19) pandemic outbreak, leading to a massive redistribution of health care resources
The objective of our study was to assess the impact of the COVID-19 pandemic on the volume of acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT), as well as pre and intra-hospital delays (Fig. 1)
We evaluated the impact of COVID-19 outbreak on a regional stroke care network
Summary
The healthcare system has been disrupted during the coronavirus disease 2019 (COVID-19) pandemic outbreak, leading to a massive redistribution of health care resources. Some studies have reported an impact of the pandemic on acute ischemic stroke (AIS) care in terms of admissions and reperfusion therapy volumes along with longer treatment times and a decrease in the use of stroke imaging compared with control periods in 2019, other reports have not detected significant effects on revascularization procedures [3,4,5,6,7,8,9,10]. Conclusions Our study showed a decrease in the volume of IVT, whereas the volume of MT remained stable intrahospital delays increased for transferred patients during the COVID-19 pandemic. These results contrast in part with the national surveys and suggest that the impact of the pandemic may depend on local stroke care networks
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