Acute Stroke Management During the COVID-19 Pandemic: Does Confinement Impact Eligibility for Endovascular Therapy?

Details

Serval ID
serval:BIB_D68722769D81
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Acute Stroke Management During the COVID-19 Pandemic: Does Confinement Impact Eligibility for Endovascular Therapy?
Journal
Stroke
Author(s)
Hajdu S.D., Pittet V., Puccinelli F., Ben Hassen W., Ben Maacha M., Blanc R., Bracco S., Broocks G., Bartolini B., Casseri T., Clarençon F., Naggara O., Eugène F., Ferré J.C., Guédon A., Houdart E., Krings T., Lehmann P., Limbucci N., Machi P., Macho J., Mandruzzato N., Nappini S., Nawka M.T., Nicholson P., Marto J.P., Pereira V., Correia M.A., Pinho-E-Melo T., Nuno Ramos J., Raz E., Ferreira P., Reis J., Shapiro M., Shotar E., van Horn N., Piotin M., Saliou G.
ISSN
1524-4628 (Electronic)
ISSN-L
0039-2499
Publication state
Published
Issued date
08/2020
Peer-reviewed
Oui
Volume
51
Number
8
Pages
2593-2596
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Observational Study
Publication Status: ppublish
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, the World Health Organization recommended measures to mitigate the outbreak such as social distancing and confinement. Since these measures have been put in place, anecdotal reports describe a decrease in the number of endovascular therapy (EVT) treatments for acute ischemic stroke due to large vessel occlusion. The purpose of our study was to determine the effect on EVT for patients with acute ischemic stroke during the COVID-19 confinement. In this retrospective, observational study, data were collected from November 1, 2019, to April 15, 2020, at 17 stroke centers in countries where confinement measures have been in place since March 2020 for the COVID-19 pandemic (Switzerland, Italy, France, Spain, Portugal, Germany, Canada, and United States). This study included 1600 patients treated by EVT for acute ischemic stroke. Date of EVT and symptom onset-to-groin puncture time were collected. Mean number of EVTs performed per hospital per 2-week interval and mean stroke onset-to-groin puncture time were calculated before confinement measures and after confinement measures. Distributions (non-normal) between the 2 groups (before COVID-19 confinement versus after COVID-19 confinement) were compared using 2-sample Wilcoxon rank-sum test. The results show a significant decrease in mean number of EVTs performed per hospital per 2-week interval between before COVID-19 confinement (9.0 [95% CI, 7.8-10.1]) and after COVID-19 confinement (6.1 [95% CI, 4.5-7.7]), (P<0.001). In addition, there is a significant increase in mean stroke onset-to-groin puncture time (P<0.001), between before COVID-19 confinement (300.3 minutes [95% CI, 285.3-315.4]) and after COVID-19 confinement (354.5 minutes [95% CI, 316.2-392.7]). Our preliminary analysis indicates a 32% reduction in EVT procedures and an estimated 54-minute increase in symptom onset-to-groin puncture time after confinement measures for COVID-19 pandemic were put into place.
Keywords
Brain Ischemia/therapy, Coronavirus Infections, Disease Management, Eligibility Determination, Endovascular Procedures/statistics & numerical data, Female, Humans, Male, Middle Aged, Pandemics, Pneumonia, Viral, Quarantine, Retrospective Studies, Spain, Stroke/therapy, Time-to-Treatment, Treatment Outcome, COVID-19, goal, groin, pandemic, standard of care
Pubmed
Create date
13/08/2020 12:19
Last modification date
18/12/2020 9:26
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