Background and purpose Spain has been heavily affected by COVID-19. Reallocation of resources for managing the outbreak might have caused a disruption in stroke care. This study analyses the impact on stroke care of reorganising the healthcare system in response to the first COVID-19 outbreak peak in Spain and the strategies adopted by Spanish stroke units to deal with this impact. Materials and methods We obtained data from a structured survey sent to the responsible of stroke units across the country. We recorded the number of strokes, stroke code activations, intravenous thrombolysis treatments and mechanical thrombectomies during February and March 2019 and 2020. We also collected information on the impact on workflow metrics and on the availability of specialised neurological care and rehabilitation treatments, the characteristics of stroke care for patients with SARS-CoV-2 infection and the impact on human resources. We compared the activity data between 2019 and 2020 and the information on activity and impact on stroke care between regions classified according to the disease incidence rate. Results Fifty-seven (75%) of all stroke units in Spain responded to the survey. There was an overall reduction in admissions for all stroke types during the outbreak’s peak and in the number of stroke code activations and intravenous thrombolysis treatments, results that were independent of the COVID-19 incidence rate. Participants reported a delay in workflow metrics and a reduction of admissions to stroke units, outpatient clinics and rehabilitation therapies. Specific pathways and protocols for managing stroke patients with SARS-CoV-2 infection have been established. Conclusion The COVID-19 outbreak has jeopardised all phases of stroke care. As a consequence, some patients with stroke did not receive adequate treatment. Data are available upon reasonable request. Data are available from the corresponding author upon reasonable request.

中文翻译：

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西班牙 COVID-19 爆发期间的卒中护理：西班牙卒中单位的经验


背景和目的 西班牙受到了 COVID-19 的严重影响。重新分配控制疫情的资源可能会导致中风护理的中断。本研究分析了为应对西班牙首个 COVID-19 疫情高峰而重组医疗保健系统对中风护理的影响，以及西班牙中风病房为应对这种影响而采取的策略。材料和方法 我们从发送给全国卒中单位负责人的结构化调查中获得了数据。我们记录了 2019 年 2 月和 3 月以及 2020 年期间的中风次数、中风代码激活、静脉溶栓治疗和机械血栓切除术。我们还收集了有关对工作流程指标的影响、专业神经护理和康复治疗的可用性、患者特征的信息。 SARS-CoV-2 感染患者的中风护理及其对人力资源的影响。我们比较了 2019 年和 2020 年的活动数据以及根据发病率分类的地区之间的活动和对中风护理的影响的信息。结果 西班牙所有卒中单位中有 57 个（75%）对调查做出了回应。在疫情爆发高峰期间，所有中风类型的入院人数以及中风代码激活和静脉溶栓治疗的数量总体有所减少，这一结果与 COVID-19 发病率无关。参与者报告了工作流程指标的延迟以及中风病房、门诊和康复治疗入院人数的减少。已经建立了管理 SARS-CoV-2 感染中风患者的具体途径和方案。结论 COVID-19 的爆发危及了中风护理的各个阶段。 结果，一些中风患者没有得到足够的治疗。数据可根据合理要求提供。数据可根据合理要求从相应作者处获取。