Background and purpose

The COVID-19 pandemic has impacted the reperfusion therapy for acute ischemic stroke (AIS) patients. Huizhou City utilized its experience with the SARS and MERS breakouts to establish a reperfusion treatment program for AIS patients.

Method

This is a retrospective study on 8 certified stroke hospitals in Huizhou City from January 2020 to May 2020. We analyzed the number of AIS patients with reperfusion therapy, stroke type (anterior/posterior circulation stroke), modes of transport to hospital, NIHSS score, onset to door time (ODT), door to needle time (DNT), and door to puncture time (DPT). The analysis was compared with baseline data from the same time period in 2019.

Result

In 2020, the number of AIS patients receiving reperfusion therapy decreased (315 vs. 377), NIHSS score increased [8 (4, 15) vs. 7 [ (1, 2)], P = 0.024], ODT increased [126 (67.5, 210.0) vs. 120.0 (64.0, 179.0), P = 0.032], and DNT decreased [40 (32.5, 55) vs. 48 (36, 59), P = 0.003]. DPT did not change. Seventy percent of AIS patients indicated self-visit as their main mode of transport to the hospital. In both periods, mild stroke patients were more likely to self-visit than utilize emergency systems [2019: 152 (57.6%) vs. 20 (45.6%), P = 0.034; 2020: 123 (56.9%) vs. 5 (14.7%), P < 0.001]. The NIHSS score for self-visiting patients was lower for patients who utilized the ambulance system in both years [self-visit: 6.00 (3.00, 12.00), ambulance: 14.00 (9.00, 19.00), P < 0.001]. The volume of reperfusion patients was lower in 2020; however, the decrease was only significant (P = 0.028) in February 2020.

Conclusion

During the COVID-19 pandemic in 2020, the number of AIS patients receiving reperfusion therapy significantly decreased when compared to the same period in 2019. The patients’ condition increased severity, ODT increased, and the DNT decreased. DPT was not significant for self-visiting and ambulance patients. Moderate to severe stroke patients were more likely to utilize ambulance services.

中文翻译：

---

COVID-19大流行对惠州市急性缺血性中风患者再灌注治疗的影响

背景和目的

COVID-19大流行影响了急性缺血性中风（AIS）患者的再灌注治疗。惠州市利用其在SARS和MERS突破方面的经验，建立了针对AIS患者的再灌注治疗计划。

方法

这项回顾性研究于2020年1月至2020年5月对惠州市8家获得认证的中风医院进行了研究。我们分析了再灌注治疗的AIS患者人数，中风类型（前/后循环中风），运输方式，NIHSS得分，起始时间为门时间（ODT），门至针时间（DNT）和门至穿刺时间（DPT）。该分析与2019年同期的基线数据进行了比较。

结果

2020年，接受再灌注治疗的AIS患者数量减少了（315比377），NIHSS评分增加了[8（4，15）vs. 7 [（1，2）]，P  = 0.024]，ODT增加了[126（ 67.5，210.0）对120.0（64.0，179.0），P  = 0.032]，DNT降低[40（32.5，55）对48（36，59），P  = 0.003]。DPT不变。百分之七十的AIS患者表示出诊是他们到医院的主要运输方式。在这两个时期中，轻度中风患者比使用急诊系统更容易自我看诊[2019：152（57.6％）对20（45.6％），P  = 0.034；2020：123（56.9％）vs.5（14.7％），P <0.001]。在这两年中使用救护车系统的患者，自诊患者的NIHSS评分均较低[自诊：6.00（3.00，12.00），救护车：14.00（9.00，19.00），P  <0.001]。2020年再灌注患者数量有所下降；然而，到 2020年2月，降幅仅是可观的（P = 0.028）。

结论

在2020年COVID-19大流行期间，与2019年同期相比，接受再灌注治疗的AIS患者数量显着减少。患者的病情加重，ODT升高，DNT降低。对于自诊和救护车患者，DPT并不重要。中度至重度中风患者更有可能使用救护车服务。