IMPROVING ACCESS TO INPATIENT AMBULATORY CARDIAC MONITORING FOR ACUTE STROKE PATIENTS DURING THE COVID-19 PANDEMIC

Introduction Ambulatory cardiac monitoring (ACM) identifies atrial fibrillation (AF) in 10.7% of patients with ischaemic stroke and no prior history of the condition. Prior to the Covid-19 pandemic, there was limited access to inpatient ACM. During the pandemic the stroke unit was provided with rapid access to inpatient ACM. Aims 1. To examine the number of inpatient and outpatient ACM performed during the pandemic and the number of these which positively identified AF. 2. to measure the mean waiting time for the ACM. Methods The records of patients in the six months prior to (n=118) and the five months during the pandemic (n=354) were analysed. Results The proportion of ACM performed as an inpatient increased from 21% to 59% during the pandemic. Inpatient rapid access ACM identified AF in 6% of patients (vs. 0% previously) and all were anticoagu-lated within 14 days of their stroke. Waiting times for inpatient ACM decreased from a mean of 17 to 4 days during the pandemic. Discussion There was a significant shift in clinical practice and diagnostic access to inpatient ACM during the pandemic, resulting in a greater proportion of tests, increased identification of AF and early anticoagulation, leading to improved patient care and potentially preventing further ischaemic events.

Modifying laboratory testing via home brew during the COVID-19 pandemic.

Rapid development and deployment of diagnostic testing for COVID-19 have been a key component of the public health response to the pandemic. Out of necessity, academic and other clinical laboratories developed laboratory testing innovations for COVID-19 to meet clinical testing demands. In addition to constraints on local testing supplies and equipment, a rapidly changing regulatory framework created challenges for translational scientists. Illustrative examples of approaches used to develop laboratory tests during the early stages of the COVID-19 pandemic demonstrate effective team science approaches to this challenging clinical care and public health emergency. These experiences and the associated lessons learned are relevant to the development of public health response plans for future pandemics.