Introduction

A reduction of the hospitalization and reperfusion treatments was reported during COVID-19 pandemic. However, high variability in results emerged, potentially due to logistic paradigms adopted. Here, we analyze stroke code admissions, hospitalizations, and stroke belt performance for ischemic stroke patients in the metropolitan Bologna region, comparing temporal trends between 2019 and 2020 to define the impact of COVID-19 on the stroke network.

Methods

This retrospective observational study included all people admitted at the Bologna Metropolitan Stroke Center in timeframes 1 March 2019–30 April 2019 (cohort-2019) and 1 March 2020–30 April 2020 (cohort-2020). Diagnosis, treatment strategy, and timing were compared between the two cohorts to define temporal trends.

Results

Overall, 283 patients were admitted to the Stroke Center, with no differences in demographic factors between cohort-2019 and cohort-2020. In cohort-2020, transient ischemic attack (TIA) was significantly less prevalent than 2019 (6.9% vs 14.4%, p = .04). Among 216 ischemic stroke patients, moderate-to-severe stroke was more represented in cohort-2020 (17.8% vs 6.2%, p = .027). Similar proportions of patients underwent reperfusion (45.9% in 2019 vs 53.4% in 2020), although a slight increase in combined treatment was detected (14.4% vs 25.4%, p = .05). Door-to-scan timing was significantly prolonged in 2020 compared with 2019 (28.4 ± 12.6 vs 36.7 ± 14.6, p = .03), although overall timing from stroke to treatment was preserved.

Conclusion

During COVID-19 pandemic, TIA and minor stroke consistently reduced compared to the same timeframe in 2019. Longer stroke-to-call and door-to-scan times, attributable to change in citizen behavior and screening at hospital arrival, did not impact on stroke-to-treatment time. Mothership model might have minimized the effects of the pandemic on the stroke care organization.

中文翻译：

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中风母舰模型在 COVID-19 时代幸存下来：意大利艾米利亚-罗马涅的一项观察性单中心研究

 介绍

据报道，在 COVID-19 大流行期间，住院和再灌注治疗有所减少。然而，结果出现了很大的可变性，这可能是由于采用的逻辑范式所致。在这里，我们分析了博洛尼亚大都市地区缺血性中风患者的中风代码入院、住院治疗和中风带表现，比较 2019 年至 2020 年的时间趋势，以确定 COVID-19 对中风网络的影响。

 方法

这项回顾性观察研究包括2019年3月1日至2019年4月30日（2019年队列）和2020年3月1日至2020年4月30日（2020年队列）期间入住博洛尼亚大都会中风中心的所有患者。对两个队列之间的诊断、治疗策略和时间进行比较，以确定时间趋势。

 结果

总体而言，中风中心收治了 283 名患者，2019 年队列和 2020 年队列之间的人口统计学因素没有差异。在 2020 年队列中，短暂性脑缺血发作 (TIA) 的发生率明显低于 2019 年（6.9% vs 14.4%， p = .04）。在 216 名缺血性中风患者中，2020 年队列中中重度中风的比例更高（17.8% vs 6.2%， p = 0.027）。尽管检测到联合治疗略有增加（14.4% vs 25.4%， p = .05），但接受再灌注的患者比例相似（2019 年为 45.9%，2020 年为 53.4%）。与 2019 年相比，2020 年的上门到扫描时间显着延长（28.4 ± 12.6 vs 36.7 ± 14.6， p = .03），尽管从中风到治疗的总体时间得以保留。

 结论

在 COVID-19 大流行期间，与 2019 年同期相比，短暂性脑缺血发作 (TIA) 和轻微中风持续减少。由于公民行为的变化和到达医院时进行筛查，中风到呼叫和上门到扫描的时间较长，但并未影响中风到治疗的时间。母舰模式可能最大限度地减少了大流行对中风护理组织的影响。