Effect of the COVID-19 pandemic and the lockdown measures on the local stroke network,Neurological Sciences

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Effect of the COVID-19 pandemic and the lockdown measures on the local stroke network
Neurological Sciences ( IF 3.3 ) Pub Date : 2021-01-15 , DOI: 10.1007/s10072-021-05045-0
Valerio Brunetti ₁ , Aldobrando Broccolini _{1,

2} , Pietro Caliandro ₁ , Riccardo Di Iorio ₁ , Mauro Monforte ₁ , Roberta Morosetti ₁ , Carla Piano ₁ , Fabio Pilato ₁ , Simone Bellavia ₂ , Jessica Marotta ₂ , Irene Scala ₂ , Alessandro Pedicelli _{2,

3} , Mariano Alberto Pennisi _{2,

4} , Anselmo Caricato _{2,

4} , Cinzia Roberti ₅ , Maria Concetta Altavista ₅ , Alessandro Valenza ₆ , Marisa Distefano ₆ , Emanuela Cecconi ₆ , Martina Fanella ₇ , Sabina Roncacci ₇ , Miriam Tasillo ₇ , Paolo Calabresi _{1,

2} , Giovanni Frisullo _{1,

8,

9} , Giacomo Della Marca _{1,

2}

Affiliation

Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS - UOC Neurologia, Rome, Italy.
Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy.
Dipartimento Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS - UOC Radiologia e Neuroradiologia, Rome, Italy.
Dipartimento Scienze dell'emergenza, anestesiologiche e della rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS - UOC Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica, Rome, Italy.
ASL Roma 1, San Filippo Neri Hospital - UOC Neurologia, Rome, Italy.
Ospedale Belcolle - UOC Neurologia, Viterbo, Italy.
Unità di Trattamento Neurovascolare (UTN) - Stroke Unit, Ospedale S. Camillo de Lellis, Rieti, Italy.
Institute of Neurology, Catholic University, Rome, Italy.
Policlinico Universitario "A. Gemelli", Largo A. Gemelli, 8, 00168, Rome, Italy.

Introduction

The COVID-19 outbreak highly impacted the acute ischemic stroke care management. The primary end point of the study was to evaluate the impact of the COVID-19 outbreak and the following lockdown measures on our hub-and-spoke network; the secondary end point was to evaluate if the impact of the COVID-19 outbreak was different in hub-and-spoke centers.

Methods

This was a retrospective multicenter observational study conducted at the Stroke Units of Policlinico Gemelli, Ospedale San Filippo Neri, Ospedale di Belcolle, and Ospedale San Camillo de Lellis. We collected clinical reports of all consecutive patients admitted with diagnosis of acute ischemic stroke or transient ischemic attack (TIA) during the phase 1 of the lockdown period (11 March 2020–4 May 2020). As controls, we used all consecutive patients admitted for acute ischemic stroke or TIA in the same period of the previous year.

Results

A total of 156 and 142 clinical reports were collected in 2019 and 2020, respectively. During the COVID-19 outbreak, we observed a reduction of number of thrombolysis, a reduction of the length of hospitalization, and an increase of pneumonia. Regarding performance indicators, we observed an increase in onset-to-door time and in door-to-groin time. We did not observe any statistically significant interaction between year (2019 vs 2020) and facility of admission (hub vs spoke) on all variables analyzed.

Discussion

Our observational study, involving hub-and-spoke stroke network of a wide regional area, indicates that the COVID-19 outbreak impacted on the acute stroke management. This impact was equally observed in hub as well as in spoke centers.

中文翻译：

COVID-19 大流行和封锁措施对局部卒中网络的影响

介绍

COVID-19 爆发对急性缺血性中风护理管理产生了很大影响。该研究的主要终点是评估 COVID-19 爆发的影响以及以下锁定措施对我们的轴辐式网络的影响；次要终点是评估 COVID-19 爆发对中心辐射中心的影响是否不同。

方法

这是一项在 Policlinico Gemelli、Ospedale San Filippo Neri、Ospedale di Belcolle 和 Ospedale San Camillo de Lellis 的卒中单位进行的回顾性多中心观察性研究。我们收集了在锁定期的第一阶段（2020 年 3 月 11 日至 2020 年 5 月 4 日）期间所有连续入院的诊断为急性缺血性中风或短暂性脑缺血发作 (TIA) 的患者的临床报告。作为对照，我们使用了上一年同期因急性缺血性卒中或 TIA 入院的所有连续患者。

结果

2019年和2020年分别收集了156份和142份临床报告。在 COVID-19 爆发期间，我们观察到溶栓次数减少、住院时间缩短和肺炎增加。关于绩效指标，我们观察到发病到门口时间和门口到腹股沟时间的增加。在分析的所有变量上，我们没有观察到年份（2019 年与 2020 年）和入院设施（中心与辐射）之间有任何统计学上显着的相互作用。