Clinical profile and outcome of non-COVID strokes during pandemic and the pre pandemic period: COVID-Stroke Study Group (CSSG) India,Journal of the Neurological Sciences

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Clinical profile and outcome of non-COVID strokes during pandemic and the pre pandemic period: COVID-Stroke Study Group (CSSG) India
Journal of the Neurological Sciences ( IF 3.6 ) Pub Date : 2021-07-16 , DOI: 10.1016/j.jns.2021.117583
Rohit Bhatia ₁ , P N Sylaja ₂ , M V Padma Srivastava ₁ , Snigdha Komakula ₁ , Thomas Iype ₃ , Rajsrinivas Parthasarathy ₄ , Dheeraj Khurana ₅ , Vibhor Pardasani ₆ , Vijaya Pamidimukkala ₇ , S Kumaravelu ₈ , Jeyaraj Pandian ₉ , Suman Kushwaha ₁₀ , Debashish Chowdhury ₁₁ , Salil Gupta ₁₂ , Srijithesh P Rajendran ₁₃ , Rajshekar Reddy ₁₄ , Jayanta Roy ₁₅ , Arvind Sharma ₁₆ , Vivek Nambiar ₁₇ , Nirendra Kumar Rai ₁₈ , Ashish Datt Upadhyay ₁₉ , Sathish Parkipandla ₁ , Mamta Bhushan Singh ₁ , Deepti Vibha ₁ , Venugopalan Y Vishnu ₁ , Roopa Rajan ₁ , Anu Gupta ₁ , Awadh Kishore Pandit ₁ , Ayush Agarwal ₁ , Shailesh B Gaikwad ₂₀ , Ajay Garg ₂₀ , Leve Joseph ₂₀ , Sapna Erat Sreedharan ₂ , Sritheja Reddy ₂ , Krishna Sreela ₂ , Dileep Ramachandran ₃ , Githin Benoy George ₃ , Praveen Panicker ₃ , M K Suresh ₂₁ , Vipul Gupta ₂₂ , Sucharita Ray ₅ , Vikas Suri ₂₃ , Chirag Ahuja ₂₄ , Kamal Kajal ₂₅ , Vivek Lal ₅ , Rakesh K Singh ₆ , Harsh Oza ₆ , Hiral Halani ₆ , Srinivasareddy Sanivarapu ₇ , Rajeshwar Sahonta ₉ , Ashish Duggal ₁₁ , Prashant Dixit ₁₂ , Girish Baburao Kulkarni ₁₃ , A V R Taallapalli ₁₃ , Mamta Parmar ₁₆ , Vamsi Chalasani ₁₇ , Manshi Kashyap ₁₈ , Biswamohan Misra ₁ , Sudheer Pachipala ₁ , P M Yogeesh ₁ , Manish Salunkhe ₁ , Pranjal Gupta ₁ ,

Affiliation

Department of Neurology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, India.
Department of Neurology, Government Medical College, Thiruvananthapuram, India.
Department of Neurology and Neurointerventional surgery, Artemis Hospital, Gurgaon, India.
Department of Neurology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Department of Neurology, Bombay Hospital, Mumbai, India.
Department of Neurology, Lalitha Super Specialities Hospital Pvt. Ltd, Guntur, India.
Department of Neurology, Ramesh Hospitals, Guntur, India.
Department of Neurology, Christian Medical College, Ludhiana, India.
Department of Neurology, Institute of Human Behavior and Allied Sciences (IBHAS), New Delhi, India.
Department of Neurology, Gobind Ballabh Pant Institute of Postgraduate Education and Research (GIPMER), New Delhi, India.
Department of Neurology, Command Hospital, Bengaluru, India.
Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), India.
Department of Neurology, Max Hospital Saket, New Delhi, India.
Department of Neurology, Institute of Neurosciences, Kolkata, India.
Zydus Hospital, BJMC & Civil Hospital, Ahmedabad, India.
Department of Neurology, Amrita Institute of Medical Sciences, Kochi, India.
Department of Neurology, All India Institute of Medical Sciences, Bhopal, India.
Department of Biostatistics, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Department of Medicine, Government Medical College, Thiruvananthapuram, India.
Department of Neurointerventional Surgery, Artemis Hospital, Gurgaon, India.
Department of Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Department of Anaesthesia, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Background

As the health systems around the world struggled to meet the challenges of COVID-19 pandemic, care of many non-COVID emergencies was affected.

Aims

The present study examined differences in the diagnosis, evaluation and management of stroke patients during a defined period in the ongoing pandemic in 2020 when compared to a similar epoch in year 2019.

Methods

The COVID stroke study group (CSSG) India, included 18 stroke centres spread across the country. Data was collected prospectively between February and July 2020 and retrospectively for the same period in 2019. Details of demographics, stroke evaluation, treatment, in-hospital and three months outcomes were collected and compared between these two time points.

Results

A total of 2549 patients were seen in both study periods; 1237 patients (48.53%) in 2019 and 1312 (51.47%) in 2020. Although the overall number of stroke patients and rates of thrombolysis were comparable, a significant decline was observed in the month of April 2020, during the initial period of the pandemic and lockdown. Endovascular treatment reduced significantly and longer door to needle and CT to needle times were observed in 2020. Although mortality was higher in 2020, proportion of patients with good outcome were similar in both the study periods.

Conclusions

Although stroke admissions and rates of thrombolysis were comparable, some work flow metrics were delayed, endovascular stroke treatment rates declined and mortality was higher during the pandemic study period. Reorganization of stroke treatment pathways during the pandemic has likely improved the stroke care delivery across the globe.

中文翻译：

大流行期间和大流行前时期非 COVID 中风的临床概况和结果：COVID 中风研究组 (CSSG) 印度

背景

随着世界各地的卫生系统努力应对 COVID-19 大流行的挑战，许多非 COVID 紧急情况的护理受到影响。

宗旨

本研究检查了在 2020 年持续大流行的特定时期内，与 2019 年的类似时期相比，中风患者在诊断、评估和管理方面的差异。

方法

印度 COVID 中风研究小组 (CSSG) 包括遍布全国的 18 个中风中心。前瞻性地收集了 2020 年 2 月至 7 月之间以及 2019 年同期的回顾性数据。收集了人口统计学、卒中评估、治疗、住院和三个月结果的详细信息，并在这两个时间点之间进行了比较。

结果

两个研究期间共有 2549 名患者；2019 年 1237 例（48.53%），2020 年 1312 例（51.47%）。尽管卒中总人数和溶栓率相当，但在大流行初期的 2020 年 4 月观察到显着下降和锁定。血管内治疗显着减少，2020 年观察到入针时间和 CT 到针时间更长。尽管 2020 年死亡率更高，但两个研究期间获得良好结果的患者比例相似。