Journal
JOURNAL OF NEUROLOGY
Volume 268, Issue 7, Pages 2314-2319Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00415-020-10199-6
Keywords
Stroke; Thrombolysis; Thrombectomy; COVID-19
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The volume of IVT decreased significantly during the COVID-19 pandemic period, while the volume of MT remained stable. However, intra-hospital delays increased for transferred patients undergoing MT.
Background The coronavirus disease 2019 (COVID-19) pandemic would have particularly affected acute stroke care. However, its impact is clearly inherent to the local stroke network conditions. We aimed to assess the impact of COVID-19 pandemic on acute stroke care in the Lyon comprehensive stroke center during this period. Methods We conducted a prospective data collection of patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT) during the COVID-19 period (from 29/02/2020 to 10/05/2020) and a control period (from 29/02/2019 to 10/05/2019). The volume of reperfusion therapies and pre and intra-hospital delays were compared during both periods. Results A total of 208 patients were included. The volume of IVT significantly decreased during the COVID-period [55 (54.5%) vs 74 (69.2%);p = 0.03]. The volume of MT remains stable over the two periods [72 (71.3%) vs 65 (60.8%);p = 0.14], but the door-to-groin puncture time increased in patients transferred for MT (237 [187-339] vs 210 [163-260];p < 0.01). The daily number of Emergency Medical Dispatch calls considerably increased (1502 [1133-2238] vs 1023 [960-1410];p < 0.01). Conclusions Our study showed a decrease in the volume of IVT, whereas the volume of MT remained stable although intra-hospital delays increased for transferred patients during the COVID-19 pandemic. These results contrast in part with the national surveys and suggest that the impact of the pandemic may depend on local stroke care networks.
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