Trends in Covid-19 and Atrial Fibrillation: A National Inpatient Sample Trend from 2020

Background: Atrial fibrillation (AF) is the most common arrhythmia in the United States. Concomitant Covid-19 infection and the outcomes of AF are unknown. Objective(s): The study's goals were to analyze the outcomes of AF during the Covid-19 pandemic. Method(s): We conducted a retrospective cohort study based on the 2020 National Inpatient Sample (NIS) of Adults (>18 years) hospitalized for AF as the primary admitting diagnosis based on the ICD-10 codes and stratified these groups into concomitant covid-19 infection vs. non-covid-19 infection. All-cause mortality was our primary outcome, while the rate of ICU admission, length of stay, hospital charges were our secondary outcomes. Temporal trends were assessed using logistic regression. Result(s): In 2020, there were 1,994,985 admissions for atrial fibrillation, out of whom 104,495 (5.3%) had concomitant Covid-19. In the 104,495 AF admissions with covid-19, the mean age was 75y and 56.8% were males. Our results, image 1, showed AF with and without concomitant Covid-19 had similar rates of comorbid conditions including HTN, DM, OSA, CAD. HFrEF, and ESRD. AF patients with Covid-19 infection had a lower prevalence of smoking (31.83% vs. 39.4%, p<.001) and alcohol use (2% vs. 4.2%, p<.001). AF patients from both groups had similar rates of stroke (1.6% vs. 1.0%, p<.001). New AF patients with concomitant Covid-19 had worsening in-hospital outcomes such as shock (12.8% vs. 3.7%, p<.001), admission to the ICU (18.1% vs. 6.4%, p<0.001), higher all-cause mortality (21.8% vs. 3.9%, p<0.001), a longer length of stay (9.96 days vs 6.08 days, p<.001), and total hospital costs ($114,387 vs. $85,830, p<.0001). The incidence of AF catheter ablation on initial hospital admission for AF Covid-19 was lower compared to the AF non-covid-19 patients (.08% vs. 1.39%, p<.001). Conclusion(s): In 2020, Covid-19 infection was an independent predictor of higher all-cause mortality, length of stay, and costs in patients admitted for atrial fibrillation. In addition, these patients were less likely to get catheter ablation on hospital admission. [Formula presented]Copyright © 2023

Improving Access to Extracranial-Intracranial Bypass Surgery in Border Hispanic Communities Utilizing Collaborative Approach Between Plastics and Neurological Surgery

INTRODUCTION: Hispanic patients such as those with Moyamoya disease are less likely to receive surgical revascularization therapy due to inequities in access (1). Our institution is a located in the Southern Texas- Mexico border region serving a largely Hispanic population. We previously referred patients for EC-IC bypass to other quaternary-care centers in Texas. While referrals were already challenging due to distance, mixed immigration status, and poor socioeconomic background of many patients;COVID-19 further exacerbated this problem with restriction of elective surgical volume. METHOD(S): A consecutive series of EC-IC bypasses performed by authors (SKD and MDLG) were retrospectively reviewed. Baseline clinical, perioperative radiographic, and post-operative outcomes were studied. All patients were offered option of a referral to a quaternary-care centers and also given local option for performing bypass surgery. Further, patients met preoperatively with both the plastic and neurological surgeon. Ultimately, decision was made by patient. RESULT(S): A total of 6 craniotomies for EC-IC bypass were performed during the study period. The diagnoses included Moyamoya in 5 cases and symptomatic intracranial atherosclerosis in one. All patients were Hispanic, female, and nonsmokers with mean age of 35.6 years. Mean preoperative HBa1c was 7.9, preoperative LDL was 82, and mean preoperative hemoglobin was 11.3. Direct bypass was performed in 40% of cases. Mean OR time was 3 hours and 7 minutes. CONCLUSION(S): We have found collaboration between plastic and neurological surgery for surgical revascularization is feasible and improved access to care for Hispanic Moyamoya disease patients residing in a border community.

Reversible parkinsonism post combined infection with COVID- 19 and typhoid

Objective: To describe a case of levo-dopa responsive parkinsonism secondary to combined COVID-19 and Enteric fever in a patient Background: The first link between viruses and parkinsonism comes from the possible relationship between lethargic encephalitis and the Spanish flu of 1918.In addition, other viruses, including West Nile virus, herpes viruses, influenza A virus, and human immunodeficiency virus (HIV), have been associated with parkinsonism Methods: A 31 years old presented with fever ,headache for 5 days followed by altered sensorium. At presentation he had neck rigidity ,was localizing to pain ,not fully oriented and not following verbal command but he had hypoxia and need nasal oxygen support.He had D-Dimer 12506,COVID-19 RTPCR positive and was treated with Remdesivir,ceftriaxone ,dexamethasone after which he had improvement in sensorium.At day 6 of illness he had generalized rigidity,bradykinesia with slow hypophonic speech and was needing support to sit and walk . A provisional diagnosis of infection related parkinsonism was considered and Cerebrospinal fluid study,MRI Brain and spine ,Blood culture were done .His Cerebrospinal fluid study has normal protein , glucose,cells, stains and culture and negative autoimmune and paraneoplastic plane . His urine culture,blood culture was positive for salmonella typhi and serum widal titre was 1:640.MRI Brain and spine does not show any new abnormalities except old trauma sequalae. He was treated with Levo-dopa carbidopa and titrated to a dose of 675 mg/day and had sustained improvement with levo-dopa carbidopa .There are 6 other case of COVID-19 associated parkinsonism in literature .There are also few case of typhoid associated case of parkinsonism described in literature . Our patient had combined infection of both COVID-19 and typhoid associated parkinsonism. Result(s): We report a case of Infection related parkinsonism secondary to combined COVID-19 plus typhoid infection Conclusion(s): Exploring the potential relationship of co-infection SARS-CoV-2 and Salmonella typhi infection with development of parkinsonism is essential because of the epidemiological implications,as well as to gain a better understanding of the pathophysiological aspects of these disorders.

COVID-19 lockdown and collective activities: Evidence from the world's largest self-help group program

We study the impact of the COVID-19 lockdown in 2020 on the monthly savings of self-help groups (SHGs) in India, and the role of SHGs in mitigating the economic effects of the lockdown. Administrative data suggest that monthly savings of SHGs declined by 66% between March and July of 2020, with larger declines in areas with more stringent lockdowns. Survey data revealed that SHG and non-SHG households had similar consumption and income losses during the lockdown. Households with SHG members and those that received assistance from SHGs in procuring ration or accessing community kitchens reported significantly higher food security, however. © 2023 Agricultural & Applied Economics Association.

Effects of Acute Exercise and Meditation on Mood and Affect in Youth

Background: Physical activity (PA) has shown to have beneficial effects on children's health and development. However, a reduced focus on PA programming in schools and home environments may contribute to the increasing prevalence of mental health problems among youth, particularly following the onset of the COVID-19 pandemic. Here, we report preliminary findings from an ongoing randomized controlled trial of acute exercise (light-intensity or moderate-intensity) and meditation on mood and affect in youth. Method(s): Youth participants recruited from the Metro Detroit area (N =25: 52% female, 48% black;Mean + SD age =12.92 + 2.18yrs) were randomly assigned to a single 30-minute session of either (1) moderate-intensity treadmill walking, (2) light-intensity stretching, or (3) a seated meditation session. Mood and positive and negative affect were measured pre- and post-session. Result(s): There was a pre-to-post-session reduction in negative mood and affect scores and an increase in positive affect (p's<0.05, d's 0.42-0.67). However, no significant main effects of condition or condition x time interaction were observed (p>0.05). Youth with higher negative baseline mood scores showed greater reductions in negative mood following the 30-minute session, as compared to youth with lower negative moods (r=0.87, p< 0.001). Conclusion(s): Acute light and moderate-intensity exercise, as well as meditation, were associated with reductions in negative mood and affect and increases in positive affect. Further, the antidepressant effects of acute exercise and meditation were more pronounced among youth with poorer baseline moods. These findings have implications for the use of PA and meditation-based interventions to combat mental health problems in youth. Funding Source: Wayne State University, National Institute of Mental Health, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development Keywords: Affect, Adolescent Depression, Mental health, exercise intervention, Mindfulness MeditationCopyright © 2023

Antiviral effect of curcumin: A special emphasis on COVID-19 virus

Plant derived biomolecules are said to possess various pharmacological actions. Curcumin obtained from rhizomes of Curcuma longa, is the primary bioactive molecule which exhibits antiviral, antinociceptive, anti-inflammatory, antipyretic and anti-fatigue effects. Recent studies reveal that curcumin also shows antiviral activity against many viruses such as dengue, hepatitis, zika, chikungunya, etc. Few research studies revealed that curcumin has binding potential to target a variety of SARSCov- 2 proteins. This chapter covers antiviral activity of curcumin with special focus on its role in inhibiting COVID-19 virus. These findings will be utilized to develop therapeutic lead using curcumin against COVID-19. © 2023 Nova Science Publishers, Inc.

Clinical, laboratory and radiological parameters of COVID 19 pneumonia: a single-centered retrospective observational study in Pune, India

Background: The severe acute respiratory syndrome coronavirus called the novel coronavirus caused the pandemic coronavirus disease 19 (COVID-19). All over the world, SARS-CoV-2 pneumonia is causing significant short-term morbidity and mortality, but the medium-term impact on lung function and quality of life of affected patients is still unknown. Aims: To assess clinical, laboratory, and radiological parameters of COVID-19 Patients and to correlate radiological findings and disease severity among patients. Methodology: In this retrospective observational study a total of 630 patients with radiologically confirmed pneumonia and COVID-19 RT PCR positive were included from a tertiary care centre in Pune, Maharashtra, following their voluntary informed consent. Patients underwent clinical, laboratory, and radiological investigations. Results: It was observed that the majority 174 (27.6%) were in the age group of 31 to 40 years and male predominance was observed compared to female. The majority of the patients 314 (49.8%) had mild, 232 (36.8%) were moderate and 84 (13.3%) had severe illness as per CT scores (HRCT Chest score). Mean BSL levels were 181 +or- 81.44, mean pulse rate was 94.03 +or- 14.93 bpm, mean respiratory rate was 22.84 +or- 3.71cpm, systolic blood pressure was 129.09 +or- 13.18 mmHg, diastolic blood pressure was 82.80 +or- 9.67 mmHg and mean temperature was 98.56 +or- 1.67 degrees F. The mean ferritin levels were 181 +or- 81.44, the mean LDH level was 94.03 +or- 14.93, mean HbA1C was 7.45 +or- 1.68. The mean NLR was 5.51 +or- 2.41, the mean WBC count was 7238.38 +or- 4942.23 and the mean hematocrit was 39.69 +or- 4.80. The mean D dimer level was 402.29 +or- 424.70, median levels were 260 (170-450). 503 (79.8%) had CRP levels more than 5 and 127 (20.2%) had levels less than 5. The mean duration of hospital stay was 9.18 days +or- 4.34 days. Majority 570 (90.5%) had fever, 493 (78.3%) had cough, 286 (45.4%) had breathlessness, 66 (10.5%) had sore throat. Other symptoms include vomiting, and loose motion in 17 (2.7%). Among 630 subjects included in the present study, the majority 584 (92.7%) have recovered/were discharged from the hospital and 46 (7.3%) succumbed to the illness. The mean SGOT and SGPT levels were 44.86+or- 31.29 and 43.60 +or- 31.25 respectively. Mean serum creatinine and BUN levels were 0.87+or- 0.80 and 13.96 +or- 9.46 respectively. The mean values of pulse rate, systolic blood pressure, diastolic blood pressure, respiratory rate and temperature showed an increasing trend across the grades of severity. Conclusion: We concluded that age, gender, blood sugar level, blood pressure, clinical symptoms, comorbidities, inflammatory biomarkers and CT severity score were independently associated with the severity and mortality based on our findings.

Improving Teaching Learning with Development of Virtual Laboratory

The pandemic Covid-19 has brought a change in the education significantly. As we all know that Education Industry was the drastically hit industry in the service sector. The future of education completely depends upon experiential learning. Now the students can find their courses and books online where they can study as per their own schedule. In these times of need, online learning tools emerged as a boon. In this regard the department tried to design and implement a web-based simulation models under Virtual BIZ & Investment Lab for the student Learners. This paper talks about the benefits of Virtual lab and how it will expose the student learners to real world problem solving and decision making issues to make them industry ready. © 2022, Rajarambapu Institute Of Technology. All rights reserved.

Myoclonus associated with infections: A narrative review

Different movement disorders are reported in association with infectious diseases. In addition, myoclonus can be associated with different types of viral and bacterial infections. We screened three electronic databases for cases of myoclonus as a feature of different infections and collected cases and series describing myoclonus associated with infections. Data regarding study design, sample size, neurological assessment, and diagnostic workup including brain imaging and cerebrospinal fluid analysis were extracted from the identified studies. In this narrative review, we review different infections associated with myoclonus and discuss their salient features. The infections presenting with myoclonus include predominantly subacute sclerosing panencephalitis due to measles. In addition, we describe other viral infections that are reported to associated with myoclonus. Recently, coronavirus disease 2019 infections have been reported to be increasingly associated with myoclonus. The hypothesized mechanisms of infection-related myoclonus are vasculopathy, autoimmune reactions, and inflammation. Although myoclonus is considered to be a result of heredodegenerative, metabolic, or autoimmune disorders, infections may present with myoclonus, especially in tropical and developing countries. In this review, we describe the infections that are associated with myoclonus. © 2022 Annals of Movement Disorders ;Published by Wolters Kluwer - Medknow.

Granulomatous Pleuritis in a Previously Covid-19-Infected Patient

INTRODUCTION: The most common setting for granulomatous pleuritis is usually in the presence of Mycobacterium tuberculosis. This pathology draws interest due to its potential of long-term injury to lung pleura, as well as, the potential to harm the lung parenchyma by association. We present a rare presentation of granulomatous pleuritis following COVID19 infection. DESCRIPTION: The patient is a 28-year-old female who presents to the hospital with fever and malaise for one week. She reports having an outpatient CT which showed a large right pleural effusion so her pulmonologist instructed her to come in. She denies recent exposure to any sick contacts. She does note a history of COVID-19 a year ago which resulted in shortness of breath but did not require hospitalization. She has worked at a gun shooting range for the last two years, for which she assembles bullets. She notes that she is required to wear a particulate protection mask and has worn this consistently to limit exposure. Thoracic surgery was consulted and initially completed a thoracentesis with 500 mL of exudative fluid. Patient remained intermittently febrile with worsening right sided chest pain. Culture and gram stain were unremarkable. She subsequently underwent a bronchoscopy with bronchial washing, biopsy, and decortication. Pathology demonstrated non-necrotic granulomatous pleuritis with a small area of central fibrinoid necrosis. Repeat chest x-rays demonstrated a minimal pleural effusion, much improved from prior. Fevers had also subsided at this time. Patient was discharged home with instructions to follow-up with thoracic surgery regarding further management of steroids. DISCUSSION: The findings of non-tuberculosis-related granulomatous pleuritis are unique in that they frame the need to look for different perspectives and potentiators for pleural pathology. This case is also important given the unique presentation of the post-covid inflammatory response. Since COVID-19 is still so new, the field of post covid syndromes remains largely unknown.

Plasma Therapy: An Effective Treatment for Infections from Microbes with Special Reference to Coronavirus Disease 2019

Infections hold a major place in the global disease burden. About thousands of different microbial species invade human body thereby leading to complications in the physiology of a particular system or the body as a whole. While the world has tried to combat the microbial infections through various natural and synthetic chemical constituents and certain additional medical aids, we still lack effective treatment against all kinds of microorganisms especially, the evolving new microbial species. Currently, as the world is suffering from a major pandemic spread of infection caused by severe acute respiratory syndrome coronavirus 2, scientists all over the world are trying to produce an effective prophylaxis as well as treatment to fight the viral attack. Amongst different trials going on, this review focuses on the effectiveness of plasma therapy, its mechanism and its applications in various infections so far and it's possible role to treat coronavirus disease 2019.

A retrospective evaluation of seroconversion after COVID-19 during the early Omicron wave in fully vaccinated MS patients receiving B-cell depletion therapies

Introduction: Patients with multiple sclerosis (MS) are commonly treated with B-cell depletion therapies (BCDTs). Reduced seroconversion following COVID-19 vaccination in patients receiving certain BCDTs has been reported, however the immune response following natural infection is poorly understood. Objective(s): This study aimed to evaluate COVID-19 antibody responses after vaccination and natural infection in BCDT-treated patients. This single-centre study evaluated COVID-19 seroconversion and spike protein antibody titres for double-vaccinated MS or neuroinflammatory disease patients treated with BCDT (n=33) with confirmed COVID-19 infection (n=16) or uninfected by COVID-19 (control;n=17). Method(s): We performed a retrospective review of patients at the Yale MS Center who had systematically checked COVID-19 spike antibody levels among patients treated with BCDTs (ocrelizumab [OCR], n=24;rituximab [RTX], n=5;ofatumumab [OFT], n=4). Data were collected from Mar 2020 to Feb 2022. All patients had received >=2 doses of FDA-approved COVID-19 vaccine. Qualitative spike antibody seropositivity was determined based on test-specific lab reference ranges. For a subset of patients (n=18), quantitative spike antibody levels were assessed via DiaSorin Liaison chemiluminescence assay (positive titre of >=13;OCR, n=13;RTX, n=3;OFT, n=2). Vaccination and COVID-19 infection dates were also recorded. Patients were monitored for health effects following COVID-19. Result(s): Overall,16/33 (48%) patients seroconverted post full vaccination. After COVID-19 infection, 15/16 (94%) seroconverted, while 7/17 (41%) of uninfected patients seroconverted after vaccination. For the 18 patients with quantitative COVID-19 spike antibody titres, mean titres post-vaccination were 37.38. Mean antibody titres were significantly higher after COVID-19 infection;540.32 vs 20.1 in the control group (p<0.05). Of the 16 infected patients, 15 had mild COVID-19 symptoms and 1 was asymptomatic. No hospitalizations or deaths were reported. Conclusion(s): This study reports that COVID-19 spike antibody titres in fully vaccinated, BCDT-treated patients were significantly increased post-infection compared to the control group. BCDT-treated patients infected with COVID-19 displayed mild infection or were asymptomatic, with no hospitalizations or deaths. These results provide reassurance that BCDTs in doublevaccinated MS patients do not preclude an appropriate COVID-19 antibody response post infection.

CHARACTERISTICS OF COVID-19 INFECTION-RELATED MYOCARDITIS: AN UPDATED SYSTEMATIC REVIEW

SESSION TITLE: Late Breaking Posters in Critical Care SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/18/2022 01:30 pm - 02:30 pm PURPOSE: This systematic review aims to better understand the clinical characteristics, comorbidities, diagnostic findings, and clinical outcomes associated with COVID-19 myocarditis. METHODS: A search for “COVID-19 OR SARS COV-2 OR Coronavirus AND Myocarditis” was performed on 1/4/2022. 2011 studies from Embase and 1165 studies from PubMed were identified. Selection criteria included studies on SARS COV-2 infection-related myocarditis. 142 PubMed and 104 Embase studies were identified. Studies were appraised per protocols and s, vaccine-related myocarditis, uncertain vaccine/infection-related myocarditis, and, systematic reviews. Duplicate studies were removed. A total of 53 articles from which 57 cases were selected to be part of this systematic review. Data on age, sex, days since diagnosis, comorbid conditions such as morbid obesity, hypertension, hyperlipidemia, CAD, preexisting CHF, ischemic heart disease, D- Dimer, ferritin, high sensitivity troponin, BNP, EKG, echocardiogram, cMRI findings, medications, ventilation requirements, and mortality were extracted from 57 studies and were analyzed using IBM SPSS v26. RESULTS: Mean EF was 32.65 ± 16.57 %. EKG findings of diffuse ST elevation were present in 22% of all cases. Echocardiogram findings of diffuse hypokinesis present in 42.1% and depressed EF in 31.6% of all cases. 21.1% required non-invasive ventilation while 26.3% of all cases ended up requiring mechanical ventilation. Ischemic cardiomyopathy was present in 1.7%, Hypertension in 24.5%, Hyperlipidemia in 7%, Morbid obesity, and a previous diagnosis of CHF was present in 0% of all cases. Overall mortality was seen in 5.3% of all cases. 50% of the cases reported using cardiac MRI (cMRI) and 58% with reported cMRI findings met the Lake Louis criteria for diagnosis of myocarditis. CONCLUSIONS: This systematic review presents findings of demographics, comorbidities, diagnostic findings, and clinical outcomes of adult COVID-19 patients with myocarditis. The mean days since COVID-19 diagnosis has a wide range due to varied presentations noted in case reports. The previously presumed high-risk factors for COVID-19-related myocarditis are not present in a significant percentage of the cases. SARS-CoV2 myocarditis-related mortality is lower in cases than expected. In the setting of the appropriate clinical context, acute/subacute chest pain, with elevated cardiac biomarkers, abnormal EKGs, and echocardiogram findings in patients with recent or /remote SARS-CoV2 infection/ vaccination, a clinical diagnosis of myocarditis can be made in absence of cMRI. CLINICAL IMPLICATIONS: Diagnosis of SARS-CoV2-related myocarditis can be made based on clinical presentation, abnormal EKG, and echocardiogram with or without the added benefit of cardiac MRI. This systematic review aims to update current knowledge on the characteristics of COVID-19 infection-related myocarditis. DISCLOSURES: No relevant relationships by Mubashir Ayaz Ahmed No relevant relationships by Hari Bhattarai No relevant relationships by shyam chalise No relevant relationships by Saral Desai No relevant relationships by Shayet Hossain Eshan No relevant relationships by Sudha Misra No relevant relationships by Zahin Islam Rafa No relevant relationships by Shrungavi Ramanathan No relevant relationships by Monica Sharma

Analysis of Research Paper Titles Containing Covid-19 Keyword Using Various Visualization Techniques

It’s been around two years from the outbreak of the coronavirus, thus labeled as Covid-19, and there has been an explosion of literature being published by research scholars related to work done on Covid-19. Covid-19 as a keyword has been mentioned in the titles of most of these papers. It was thought to analyse the number of papers and the titles of papers which include Covid-19 in the title of the research papers. The various combinations of other words like, prefixes, suffixes, N-gram combinations with the keyword Covid- 19 in the titles of these papers were also analysed. The research publication repositories analysed were: IEEE Explore, ACM Digital Library, Semantic Scholar, Google Scholar, Cornel University etc. The domains of research publication title analysis were restricted to computer science/computer engineering related papers. As the term labeling the corona virus outbreak as Covid-19 was labeled in 2020, the timeline of title analysis was restricted from 2019 till December 2021. The term Covid-19 is also one of the most searched terms in most of these research repositories as is evident from the search suggestions offered by them. Considering the usefulness of Bag of Words and N Gram algorithm in analytics and data visualization, a methodology is proposed and implemented based on bag of words algorithm to do prefix and suffix words analysis. This methodology is working correctly to state different prefix and suffix words used by various researchers to demonstrate significance of their titles. Methodology based on N Gram analysis is found effective to find topic on which most of the researchers have done work. Word Clouds are generated to demonstrate different buzz words used by researchers in their respective paper titles. These are useful for providing visualization of the data if it is in big size. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Factors influencing international collaboration on the prevention of COVID-19.

OBJECTIVES: COVID-19 has spread rapidly throughout the world, which has highlighted the importance of collaboration between countries to prevent further transmission of the virus. This review aims to identify the factors that influence international collaboration between policymakers for COVID-19 prevention and consider strategies to manage pandemics in the future. STUDY DESIGN: A scoping review was conducted using the Arksey and O'Malley framework for scoping reviews. METHODS: A literature search was performed across PubMed, Google Scholar, Scopus and Embase databases using relevant keywords. The initial search identified 1010 articles; after selection criteria were applied, 28 studies were included in the review. RESULTS: Most of the selected articles were literature reviews, and China had the greatest contribution of articles to this study. The following seven key categories influencing international collaboration were identified: political, structure, infrastructure, leadership and governance, knowledge and information sharing, community engagement, and process/action. CONCLUSION: Leadership and governance was the most important factor identified in international collaboration between countries. In addition, knowledge and information sharing were seen to help avoid repetition of negative situations experienced in other countries. Moreover, controlling COVID-19 on a global scale is more likely to be achieved when there are sufficient structures and resources and when appropriate communication between countries, health systems and communities is used. This collaboration can also greatly benefit low- and middle-income countries where resources and expertise are often limited.

Delaysin thrombolysis during COVID-19 are associated with worse neurological outcomes: the Society of Vascular and Interventional Neurology Multicenter Collaboration

Objective: To investigate whether delays in intravenous thrombolysis (IVT) administration during the Coronavirus (COVID-19) pandemic for patients with suspected acute ischemic stroke are associated with worse neurologic outcomes. Background: The COVID-19 pandemic has had a deleterious impact on health care systems across the world. Delays in presentation and management of emergent medical conditions like myocardial infarction, and stroke have been reported with a recent multicenter cohort study demonstrating that the COVID-19 pandemic has led to delays in IVT administration. It is unknown if these delays contribute to meaningful differences in short-term outcomes. Design/Methods: This was a nested observational cohort study of adult acute ischemic stroke patients receiving IVT from 9 comprehensive stroke centers in 7 states across the United States. Patients admitted prior to the pandemic (1/1/2019-2/19/2020) were compared to those admitted during the early pandemic (3/1/2020-7/31/2020). The effect of delay in IVT administration on death and discharge destination was estimated using multivariable logistic regression model. Results: There were 676 patients who received IVT with a median age of 70 (IQR 58-81) years and median NIHSS of 8 (IQR 4-16). 313 patients (46.3%) were female. During the early COVID19 period, longer treatment delays were observed (median 46 versus 38 minutes, p=0.01) that were associated with higher in-hospital death or hospice discharge (OR per hour 1.08, 95% CI 1.01-1.17, p = 0.03). After multivariable adjustment, this effect was strengthened (aOR 1.15, 95% CI 1.07-1.24, p < 0.001). Each hour delay in IVT administration was also associated with 7% lower odds of being discharged home or to a rehabilitation facility (aOR 0.93, 95% CI 0.89-0.97, p < 0.001). Conclusions: Treatment delays observed during the COVID-19 pandemic led to worse shortterm outcomes with higher rates of mortality and hospice care along with lower rates of discharge to home or rehabilitation facility.