Impact of COVID-19 outbreak in reperfusion therapies of acute ischaemic stroke in northwest Spain.
Adult
Aged
Aged, 80 and over
COVID-19
Emergency Medical Services
/ statistics & numerical data
Endovascular Procedures
/ statistics & numerical data
Female
Humans
Ischemic Stroke
/ epidemiology
Length of Stay
Male
Middle Aged
Pandemics
Patient Admission
/ statistics & numerical data
Registries
Reperfusion
Retrospective Studies
Spain
/ epidemiology
Thrombolytic Therapy
/ statistics & numerical data
Treatment Outcome
COVID-19
Spain
acute stroke therapy
cerebral infarction
ischaemic stroke
thrombectomy
thrombolysis
Journal
European journal of neurology
ISSN: 1468-1331
Titre abrégé: Eur J Neurol
Pays: England
ID NLM: 9506311
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
24
06
2020
accepted:
01
08
2020
pubmed:
8
8
2020
medline:
18
12
2020
entrez:
8
8
2020
Statut:
ppublish
Résumé
Spain has been one of the countries more heavily stricken by SARS-CoV-2, which has had huge implications for stroke care. The aim was to analyse the impact of the COVID-19 epidemic outbreak on reperfusion therapies for acute ischaemic stroke in the northwest of Spain. This was a Spanish multicentre retrospective observational study based on data from tertiary hospitals of the NORDICTUS network. All patients receiving reperfusion therapy for ischaemic stroke between 30 December 2019 and 3 May 2020 were recorded, and their baseline, clinical and radiological characteristics, extra- and intra-hospital times of action, Code Stroke activation pathway, COVID-19 status, reperfusion rate, and short-term outcome before and after the setting of the emergency state were analysed. A total of 796 patients received reperfusion therapies for ischaemic stroke. There was a decrease in the number of patients treated per week (46.5 patients per week vs. 39.0 patients per week, P = 0.043) and a delay in out-of-hospital (95.0 vs. 110.0 min, P = 0.001) and door-to-needle times (51.0 vs. 55.0, P = 0.038). Patients receiving endovascular therapy obtained less successful reperfusion rates (92.9% vs. 86.6%, P = 0.016). COVID-19 patients had more in-hospital mortality. A decrease in the number of patients benefiting from reperfusion therapies was found, with a delay in out-of-hospital and door-to-needle times and worse reperfusion rates in northwest Spain. COVID-19 patients had more in-hospital mortality.
Sections du résumé
BACKGROUND AND PURPOSE
Spain has been one of the countries more heavily stricken by SARS-CoV-2, which has had huge implications for stroke care. The aim was to analyse the impact of the COVID-19 epidemic outbreak on reperfusion therapies for acute ischaemic stroke in the northwest of Spain.
METHODS
This was a Spanish multicentre retrospective observational study based on data from tertiary hospitals of the NORDICTUS network. All patients receiving reperfusion therapy for ischaemic stroke between 30 December 2019 and 3 May 2020 were recorded, and their baseline, clinical and radiological characteristics, extra- and intra-hospital times of action, Code Stroke activation pathway, COVID-19 status, reperfusion rate, and short-term outcome before and after the setting of the emergency state were analysed.
RESULTS
A total of 796 patients received reperfusion therapies for ischaemic stroke. There was a decrease in the number of patients treated per week (46.5 patients per week vs. 39.0 patients per week, P = 0.043) and a delay in out-of-hospital (95.0 vs. 110.0 min, P = 0.001) and door-to-needle times (51.0 vs. 55.0, P = 0.038). Patients receiving endovascular therapy obtained less successful reperfusion rates (92.9% vs. 86.6%, P = 0.016). COVID-19 patients had more in-hospital mortality.
CONCLUSION
A decrease in the number of patients benefiting from reperfusion therapies was found, with a delay in out-of-hospital and door-to-needle times and worse reperfusion rates in northwest Spain. COVID-19 patients had more in-hospital mortality.
Identifiants
pubmed: 32761981
doi: 10.1111/ene.14467
pmc: PMC7436392
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
2491-2498Informations de copyright
© 2020 European Academy of Neurology.
Références
Lancet. 2014 Nov 29;384(9958):1929-35
pubmed: 25106063
Lancet. 2020 Jul 4;396(10243):27-38
pubmed: 32479829
Am J Hematol. 2020 Jul;95(7):834-847
pubmed: 32282949
Ann Clin Transl Neurol. 2018 Mar 14;5(4):456-463
pubmed: 29687022
Stroke. 2020 Aug;51(8):2307-2314
pubmed: 32466738
Eur J Neurol. 2020 Sep;27(9):1788-1792
pubmed: 32415888
Lancet. 2016 Apr 23;387(10029):1723-31
pubmed: 26898852
Stroke. 2020 Jul;51(7):1996-2001
pubmed: 32432997
N Engl J Med. 2020 Mar 26;382(13):1268-1269
pubmed: 32109011
J Stroke Cerebrovasc Dis. 2020 Aug;29(8):104949
pubmed: 32410807
N Engl J Med. 1995 Dec 14;333(24):1581-7
pubmed: 7477192
Stroke. 2020 Jul;51(7):1991-1995
pubmed: 32438895
BMJ. 2020 Mar 29;368:m1282
pubmed: 32224494
Acta Biomed. 2020 Mar 19;91(1):157-160
pubmed: 32191675
JAMA Neurol. 2020 Jun 1;77(6):683-690
pubmed: 32275288
Int J Stroke. 2020 Oct;15(7):755-762
pubmed: 32525468