Break in the Stroke Chain of Survival due to COVID-19.
COVID-19
Coronavirus Infections
/ epidemiology
Emergency Medical Services
Hospital Units
/ statistics & numerical data
Humans
Pandemics
Patient Care
Patient Transfer
Pneumonia, Viral
/ epidemiology
Reperfusion
Spain
/ epidemiology
Stroke
/ epidemiology
Survival Analysis
Telemedicine
Thrombolytic Therapy
Time-to-Treatment
Tissue Plasminogen Activator
/ therapeutic use
acute disease
coronavirus
diagnosis
pandemics
reperfusion
stroke
Journal
Stroke
ISSN: 1524-4628
Titre abrégé: Stroke
Pays: United States
ID NLM: 0235266
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
pubmed:
30
5
2020
medline:
7
8
2020
entrez:
30
5
2020
Statut:
ppublish
Résumé
Emergency measures to treat patients with coronavirus disease 2019 (COVID-19) and contain the outbreak is the main priority in each of our hospitals; however, these measures are likely to result in collateral damage among patients with other acute diseases. Here, we investigate whether the COVID-19 pandemic affects acute stroke care through interruptions in the stroke chain of survival. A descriptive analysis of acute stroke care activity before and after the COVID-19 outbreak is given for a stroke network in southern Europe. To quantify the impact of the pandemic, the number of stroke code activations, ambulance transfers, consultations through telestroke, stroke unit admissions, and reperfusion therapy times and rates are described in temporal relationship with the rising number of COVID-19 cases in the region. Following confinement of the population, our stroke unit activity decreased sharply, with a 25% reduction in admitted cases (mean number of 58 cases every 15 days in previous months to 44 cases in the 15 days after the outbreak, The COVID-19 pandemic is disruptive for acute stroke pathways. Bottlenecks in the access and delivery of patients to our secured stroke centers are among the main challenges. It is critical to encourage patients to continue seeking emergency care if experiencing acute stroke symptoms and to ensure that emergency professionals continue to use stroke code activation and telestroke networks.
Sections du résumé
BACKGROUND AND PURPOSE
Emergency measures to treat patients with coronavirus disease 2019 (COVID-19) and contain the outbreak is the main priority in each of our hospitals; however, these measures are likely to result in collateral damage among patients with other acute diseases. Here, we investigate whether the COVID-19 pandemic affects acute stroke care through interruptions in the stroke chain of survival.
METHODS
A descriptive analysis of acute stroke care activity before and after the COVID-19 outbreak is given for a stroke network in southern Europe. To quantify the impact of the pandemic, the number of stroke code activations, ambulance transfers, consultations through telestroke, stroke unit admissions, and reperfusion therapy times and rates are described in temporal relationship with the rising number of COVID-19 cases in the region.
RESULTS
Following confinement of the population, our stroke unit activity decreased sharply, with a 25% reduction in admitted cases (mean number of 58 cases every 15 days in previous months to 44 cases in the 15 days after the outbreak,
CONCLUSIONS
The COVID-19 pandemic is disruptive for acute stroke pathways. Bottlenecks in the access and delivery of patients to our secured stroke centers are among the main challenges. It is critical to encourage patients to continue seeking emergency care if experiencing acute stroke symptoms and to ensure that emergency professionals continue to use stroke code activation and telestroke networks.
Identifiants
pubmed: 32466738
doi: 10.1161/STROKEAHA.120.030106
pmc: PMC7282408
doi:
Substances chimiques
Tissue Plasminogen Activator
EC 3.4.21.68
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2307-2314Références
Stroke. 2020 May;51(5):1356-1357
pubmed: 32228369
J Am Coll Cardiol. 2020 May 12;75(18):2352-2371
pubmed: 32201335
Stroke. 2017 Sep;48(9):2419-2425
pubmed: 28716979
Lancet Public Health. 2020 May;5(5):e251-e252
pubmed: 32199083
Int J Stroke. 2020 Jul;15(5):540-554
pubmed: 32362244
Yonsei Med J. 2019 Aug;60(8):796-803
pubmed: 31347336
J Thromb Haemost. 2020 May;18(5):1094-1099
pubmed: 32220112
Circ Cardiovasc Qual Outcomes. 2020 Apr;13(4):e006631
pubmed: 32182131
Eur J Neurol. 2020 Sep;27(9):e35-e36
pubmed: 32352618
Stroke. 2020 Jun;51(6):1891-1895
pubmed: 32233980
Stroke. 2020 Jun;51(6):1910-1912
pubmed: 32233972