Background To evaluate overall ischemic stroke volumes and rates, specific subtypes, and clinical presentation during the COVID-19 pandemic in a multicenter observational study from eight states across US. Methods We compared all ischemic strokes admitted between January 2019 and May 2020, grouped as; March-May 2020 (COVID-19 period) and March-May 2019 (seasonal pre-COVID-19 period). Primary outcome was stroke severity at admission measured by NIHSS stratified as mild (0−7), moderate [8–14], and severe (>14). Secondary outcomes were volume of large vessel occlusions (LVOs), stroke etiology, IV-tPA rates, and discharge disposition. Results Of the 7969 patients diagnosed with acute ischemic stroke during the study period, 933 (12 %) presented in the COVID-19 period while 1319 (17 %) presented in the seasonal pre-COVID-19 period. Significant decline was observed in the mean weekly volumes of newly diagnosed ischemic strokes (98 ± 3 vs 50 ± 20,p = 0.003), LVOs (16.5 ± 3.8 vs 8.3 ± 5.9,p = 0.008), and IV-tPA (10.9 ± 3.4 vs 5.3 ± 2.9,p = 0.0047), whereas the mean weekly proportion of LVOs (18 % ±5 vs 16 % ±7,p = 0.24) and IV-tPA (10.4 % ±4.5 vs. 9.9 % ±2.4,p = 0.66) remained the same, when compared to the seasonal pre-COVID-19 period. Additionally, an increased proportion of patients presented with a severe disease (NIHSS > 14) during the COVID-19 period (29.7 % vs 24.5 %,p < 0.025). The odds of being discharged to home were 26 % greater in the COVID-19 period when compared to seasonal pre-COVID-19 period (OR:1.26, 95 % CI:1.07–1.49,p = 0.016). Conclusions During COVID-19 period there was a decrease in volume of newly diagnosed ischemic stroke cases and IV-tPA administration. Patients admitted to the hospital had severe neurological clinical presentation and were more likely to discharge home.

中文翻译：

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COVID-19 大流行期间轻度中风症状和静脉溶栓的减少：SVIN 多中心合作


背景 在美国八个州开展的一项多中心观察性研究中，旨在评估 COVID-19 大流行期间总体缺血性中风量和发生率、具体亚型和临床表现。方法 我们比较了 2019 年 1 月至 2020 年 5 月期间收治的所有缺血性中风，分为： 2020 年 3 月至 5 月（新冠肺炎 (COVID-19) 期间）和 2019 年 3 月至 5 月（新冠肺炎 (COVID-19) 爆发前的季节性时期）。主要结局是入院时由 NIHSS 测量的卒中严重程度，分为轻度 (0−7)、中度 [8–14] 和重度 (>14)。次要结果是大血管闭塞 (LVO) 体积、卒中病因、IV-tPA 率和出院处置。结果 在研究期间诊断为急性缺血性中风的 7969 名患者中，933 名 (12%) 患者在 COVID-19 期间就诊，而 1319 名患者 (17%) 在 COVID-19 之前的季节性期间就诊。新诊断的缺血性中风的平均每周体积显着下降（98 ± 3 vs 50 ± 20，p = 0.003）、LVO（16.5 ± 3.8 vs 8.3 ± 5.9，p = 0.008）和 IV-tPA（10.9 ± 3.4 与 5.3 ± 2.9，p = 0.0047），而 LVO 的平均每周比例（18 % ±5 与 16 % ±7，p = 0.24）和 IV-tPA（10.4 % ±4.5 与 9.9 % ±2.4，p） = 0.66）与 COVID-19 之前的季节性时期相比保持不变。此外，在 COVID-19 期间，患有严重疾病 (NIHSS > 14) 的患者比例有所增加（29.7 % vs 24.5 %，p < 0.025）。与 COVID-19 之前的季节性时期相比，COVID-19 期间出院回家的几率高出 26%（OR：1.26，95% CI：1.07–1.49，p = 0.016）。结论 在 COVID-19 期间，新诊断的缺血性卒中病例和 IV-tPA 给药量有所减少。 入院的患者有严重的神经临床表现，更有可能出院回家。