Abstract
We investigated the impact of regionally imposed social and healthcare restrictions due to coronavirus disease 2019 (COVID-19) to the time metrics in the management of acute ischemic stroke patients admitted at the regional stroke referral site for Central South Ontario, Canada. We compared relevant time metrics between patients with acute ischemic stroke receiving intravenous tissue plasminogen activator (tPA) and/or endovascular thrombectomy (EVT) before and after the declared restrictions and state of emergency imposed in our region (March 17, 2020). We identified a significant increase in the median door-to-CT times for patients receiving intravenous tPA (19 min, interquartile range (IQR): 14-27 min vs. 13 min, IQR: 9-17 min, p = 0.008) and/or EVT (20 min, IQR: 15-33 min vs. 11 min, IQR: 5-20 min, p = 0.035) after the start of social and healthcare restrictions in our region compared to the previous 12 months. For patients receiving intravenous tPA treatment, we also found a significant increase (p = 0.005) in the median door-to-needle time (61 min, IQR: 46-72 min vs. 37 min, IQR: 30-50 min). No delays in the time from symptom onset to hospital presentation were uncovered for patients receiving tPA and/or endovascular reperfusion treatments in the first 1.5 months after the establishment of regional and institutional restrictions due to the COVID-19 pandemic. We detected an increase in our institutional time to treatment metrics for acute ischemic stroke patients receiving tPA and/or endovascular reperfusion therapies, related to delays from hospital presentation to the acquisition of cranial CT imaging for both tPA- and EVT-treated patients, and an added delay to treatment with tPA.
Highlights
The severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), originally emerging in Wuhan, has quickly spread worldwide and coronavirus disease 2019 (COVID-19) was declared as a pandemic outbreak on March 11, 2020.1 Reports have emerged globally on the impact of the COVID-19 pandemic on the management of stroke patients
For acute ischemic stroke patients treated with endovascular thrombectomy (EVT), we detected a significant increase in door-to-CT (20 min, interquartile ranges (IQRs): 15–33 min vs. 11 min, IQR: 5–20 min, p = 0.035; Figure 3B) and angiography suite arrival-to-groin puncture times
We identified an increase in our institutional in-hospital time to treatment metrics on the administration of both tissue plasminogen activator (tPA) and endovascular reperfusion therapies for patients with acute
Summary
The severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), originally emerging in Wuhan, has quickly spread worldwide and coronavirus disease 2019 (COVID-19) was declared as a pandemic outbreak on March 11, 2020.1 Reports have emerged globally on the impact of the COVID-19 pandemic on the management of stroke patients. We investigate the impact of regionally imposed social and healthcare restrictions to the quality of care time metrics in the hyperacute management of patients presenting with acute ischemic strokes to a large comprehensive stroke center in Ontario, Canada. Results: We identified a significant increase in the median door-to-CT times for patients receiving intravenous tPA (19 min, interquartile range (IQR): 14–27 min vs 13 min, IQR: 9–17 min, p = 0.008) and/or EVT (20 min, IQR: 15–33 min vs min, IQR: 5–20 min, p = 0.035) after the start of social and healthcare restrictions in our region compared to the previous months. No delays in the time from symptom onset to hospital presentation were uncovered for patients receiving tPA and/or endovascular reperfusion treatments in the first 1.5 months after the establishment of regional and institutional restrictions due to the COVID-19 pandemic. Conclusion: We detected an increase in our institutional time to treatment metrics for acute ischemic stroke patients receiving tPA and/or endovascular reperfusion therapies, related to delays from hospital presentation to the acquisition of cranial CT imaging for both tPA- and EVT-treated patients, and an added delay to treatment with tPA
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
