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Impact of COVID-19 on Acute Stroke Presentation at a Comprehensive Stroke Center.
Frontiers in Neurology ( IF 2.7 ) Pub Date : 2020-08-14 , DOI: 10.3389/fneur.2020.00850
Masaki Nagamine 1 , Daniel S Chow 2, 3 , Peter D Chang 2, 3 , Bernadette Boden-Albala 4 , Wengui Yu 1 , Jennifer E Soun 2
Affiliation  

Background: COVID-19 has impacted healthcare in many ways, including presentation of acute stroke. Since time-sensitive thrombolysis is essential for reducing morbidity and mortality in acute stroke, any delays due to the pandemic can have serious consequences. Methods: We retrospectively reviewed the electronic medical records for patients presenting with acute ischemic stroke at a comprehensive stroke center in March-April 2020 (the early months of COVID-19) and compared to the same time period in 2019. Stroke metrics such as incidence, time to arrival, and immediate outcomes were assessed. Results: There were 48 acute ischemic strokes (of which 7 were transfers) in March-April 2020 compared to 64 (of which 12 were transfers) in 2019. The average last known well to arrival time (±SD) for stroke codes was 1,041 (±1682.1) min in 2020 and 554 (±604.9) min in 2019. Of the patients presenting directly to the ED with a known last known well time, 27.8% (10/36) presented in the first 4.5 h in 2020, in contrast to 40.5% (15/37) in 2019. Patients who died comprised 10.4% of the stroke cohort in 2020 (5/48) compared to 6.3% in 2019 (4/64). Conclusions: During the first 2 months of COVID-19, there were fewer overall stroke cases who presented to our hospital, and of these cases, there was delayed presentation in comparison to the same time period in 2019. Recognizing how stroke presentation may be affected by COVID-19 would allow for optimization of established stroke triage algorithms in order to ensure safe and timely delivery of stroke care during a pandemic.

中文翻译:

综合性卒中中心中COVID-19对急性卒中表现的影响。

背景:COVID-19已从许​​多方面影响医疗保健,包括急性中风的表现。由于对时间敏感的溶栓作用对于降低急性中风的发病率和死亡率至关重要,因此大流行引起的任何延误都可能造成严重后果。方法:我们回顾性分析了2020年3月至4月(COVID-19的早期)在综合性卒中中心出现急性缺血性卒中的患者的电子病历,并将其与2019年同期进行了比较。 ,到达时间和即时结果进行了评估。结果:2020年3月至4月发生了48次急性缺血性卒中(其中7次为转移),而2019年为64次(其中12次为转移)。卒中代码的平均最近到达时间(±SD)为1,041 (2020年为(±1682.1)分钟)和554(±604。在2019年9月9日结束。在直接就诊于ED且已知时间最近的患者中,有2.78%(10/36)在2020年的前4.5小时内出现,而2019年为40.5%(15/37) 2020年,死亡的患者占中风队列的10.4%(5/48),而2019年为6.3%(4/64)。结论:在COVID-19的前两个月,到我院就诊的中风总病例较少,其中这些病例的延误时间与2019年同期相比有所下降。认识到中风表现可能受到的影响由COVID-19撰写的报告将允许对已建立的中风分类算法进行优化,以确保在大流行期间安全,及时地提供中风护理。2020年为5小时,而2019年为40.5%(15/37)。死亡患者占2020年中风队列的10.4%(5/48),而2019年为6.3%(4/64)。结论:在COVID-19的前两个月,到我院就诊的总中风病例较少,其中这些病例与2019年同期相比延误了病情。认识到中风表现可能受到的影响由COVID-19撰写的报告将允许对已建立的中风分类算法进行优化,以确保在大流行期间安全,及时地提供中风护理。2020年为5小时,而2019年为40.5%(15/37)。死亡患者占2020年中风队列的10.4%(5/48),而2019年为6.3%(4/64)。结论:在COVID-19的前两个月,到我院就诊的总中风病例较少,其中这些病例与2019年同期相比延误了病情。认识到中风表现可能受到的影响由COVID-19撰写的报告将允许对已建立的中风分类算法进行优化,以确保在大流行期间安全,及时地提供中风护理。
更新日期:2020-08-14
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