Introduction

The coronavirus disease (COVID-19) pandemic has changed routine clinical practice worldwide with major impacts on the provision of care and treatment for stroke patients.

Methods

This retrospective observational study included all patients admitted to the Royal Stoke University Hospital in Stoke-on-Trent, UK, with a stroke or transient ischaemic attack between March 15th and April 14th, 2020 (COVID). Patient demographics, characteristics of the stroke, treatment details and logistics were compared with patients admitted in the corresponding weeks in the year before (2019).

Results

There was a 39.5% (n = 101 vs n = 167) reduction in admissions in the COVID cohort compared with 2019 with more severe strokes (median National Institutes of Health Stroke Scale (NIHSS) 7 vs 4, p = 0.02), and fewer strokes with no visible acute pathology (21.8 vs 37.1%, p = 0.01) on computed tomography. There was no statistically significant difference in the rates of thrombolysis (10.9 vs 13.2%, p = 0.72) and/or thrombectomy (5.9 vs 4.8%, p = 0.90) and no statistically significant difference in time from stroke onset to arrival at hospital (734 vs 576 min, p = 0.34), door-to-needle time for thrombolysis (54 vs 64 min, p = 0.43) and door-to-thrombectomy time (181 vs 445 min, p = 0.72). Thirty-day mortality was not significantly higher in the COVID year (10.9 vs 8.9%, p = 0.77). None of the 7 stroke patients infected with COVID-19 died.

Conclusions

During the COVID-19 pandemic, the number of stroke admissions fell, and stroke severity increased. There was no statistically significant change in the delivery of thrombolysis and mechanical thrombectomy and no increase in mortality.

中文翻译：

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COVID-19 对英国综合卒中中心的卒中入院、治疗和结果的影响

 介绍

冠状病毒病（COVID-19）大流行改变了世界范围内的常规临床实践，对中风患者的护理和治疗产生了重大影响。

 方法

这项回顾性观察研究纳入了 2020 年 3 月 15 日至 4 月 14 日（新冠肺炎）期间入住英国特伦特河畔斯托克皇家斯托克大学医院的所有中风或短暂性脑缺血发作患者。将患者人口统计数据、中风特征、治疗细节和后勤工作与前一年（2019 年）相应周入院的患者进行比较。

 结果

与 2019 年相比，新冠肺炎队列的入院人数减少了 39.5%（ n = 101 vs n = 167），其中中风较严重（美国国立卫生研究院中风量表 (NIHSS) 中位数为 7 vs 4， p = 0.02），且中风较少计算机断层扫描显示无明显急性病理的中风（21.8% vs 37.1%， p = 0.01）。溶栓（10.9% vs 13.2%， p = 0.72）和/或血栓切除率（5.9 vs 4.8%， p = 0.90）没有统计学显着差异，并且从卒中发病到到达医院的时间没有统计学显着差异（ 734 vs 576 分钟， p = 0.34）、溶栓门到针时间（54 vs 64 分钟， p = 0.43）和门到血栓切除时间（181 vs 445 分钟，p = 0.72）。新冠疫情年份的 30 天死亡率并没有显着升高（10.9% vs 8.9%， p = 0.77）。感染 COVID-19 的 7 名中风患者无一死亡。

 结论

在 COVID-19 大流行期间，中风入院人数下降，中风严重程度增加。溶栓和机械血栓切除术的实施没有统计学上的显着变化，死亡率也没有增加。