Management of Endovascular Treatment for Acute Ischemic Stroke During the COVID-19 Pandemic at a Single Institution in Beijing, China: A Brief Report.

BACKGROUND: The coronavirus disease (COVID-19) pandemic is currently a major challenge for health care systems around the world. For a time-sensitive emergency such as acute ischemic stroke (AIS), streamlined workflow times are essential to ensure good clinical outcomes. METHODS: The aim of this single-center, retrospective, observational study was to describe changes in stroke workflow patterns and clinical care during the COVID-19 pandemic. Data from AIS patients undergoing emergent endovascular treatment (EVT) between 23 January and 8 April 2020 were retrospectively collected and compared with data from patients admitted during a similar period in 2019. The primary outcome was difference in time from symptom onset to recanalization. Secondary outcomes included workflow times, clinical management, discharge outcomes, and health-economic data. RESULTS: In all, 21 AIS patients were admitted for emergent EVT during the 77-day study period, compared with 42 cases in 2019. Median time from symptom onset to recanalization was 132 minutes longer during the pandemic compared with the previous year (672 vs. 540 min, P=0.049). Patients admitted during the pandemic had a higher likelihood of endotracheal intubation (84.6% vs. 42.4%, P<0.05) and a higher incidence of delayed extubation after EVT (69.2% vs. 45.5%, P<0.05). National Institutes of Health Stroke Scale at hospital discharge was similar in the 2 cohorts, whereas neurointensive care unit stay was longer in patients admitted during the pandemic (10 vs. 7 days, P=0.013) and hospitalization costs were higher (123.9 vs. 95.2 thousand Chinese Yuan, P=0.052). CONCLUSION: Disruptions to medical services during the COVID-19 pandemic has particularly impacted AIS patients undergoing emergent EVT, resulting in increased workflow times. A structured and multidisciplinary protocol should be implemented to minimize treatment delays and maximize patient outcomes.

Practice on infection control during the outbreak of COVID-19 from medical team of Beijing municipal hospital for aiding Hubei province

OBJECTIVE: To assist the prevention and treatment of COVID-19 in Wuhan city, Beijing municipal health commission and Beijing hospitals authority set up a medical team of 138 experts from 13 Beijing municipal hospitals, which was dispatched to Wuhan union hospital west campus to participate in the treatment of severe patients. We will give full play to the role of hospital infection prevention and control experts in our work, and ensure the strict implementation of hospital infection prevention and control requirements such as the protection of medical staff. METHODS: After arriving in Wuhan, Beijing aid medical team of Hubei province defined the mission, established the rules and regulations for infection control, and conducted standardized procedures and protection training for all the team members and the medical staff in the west hospital of Wuhan union hospital. It took 24 hours to complete the transformation of the ward, build a reasonable layout of the demonstration ward of "Beijing standard", and start the treatment of COVID-19 confirmed patients. While the work was carried out rapidly, the disinfection of the ward and residence was strengthened, which laid the foundation for medical and nursing safety. RESULTS: The medical team has been working continuously for 50 days, receiving and treating 341 patients including 216 severe patients, 83 critically ill patients and 142 cured. As of March 16 2020, the number of patients in the hospital is gradually decreasing, with the utilization rate of beds dropping from 100.00% (150/150) to 70.67% (106/150). The proportion of critically ill patients dropped from a peak of 98.00%(147/150) to 74.67% (112/150), and the number of patients cured and discharged increased significantly. Zero infection was achieved for all health care workers. CONCLUSION: This paper summarizes a series of prevention and control measures taken by the infection control team during the work in prevention and control of novel coronavirus pneumonia in Wuhan union hospital west campus, which provides a reference for the prevention and control of the outbreak of infectious diseases.

The Perioperative Management of Subarachnoid Hemorrhage During the Coronavirus Disease 2019 Pandemic in China.

BACKGROUND: For most of the international community outside the epicenter, coronavirus disease 2019 (COVID-19) containment is normalizing, and daily medical practice runs parallel to preventing and treating COVID-19. This experience of simultaneously conducting emergent surgery and infection control for COVID-19 disease is useful outside the epicenter during the pandemic. CASE DESCRIPTION: In this single-center retrospective observational study, we enrolled patients with subarachnoid hemorrhage (SAH) who were emergently admitted from January 23 to April 8, 2020. Based on the COVID-19 triage, patients with SAH were divided into 3 categories: positive, negative, and under investigation. During 77 days, 90 patients with SAH were admitted at the center. The median age was 55 years (range, 18-80 years) and 40 patients (44.4%) were male. None was positive, 42 patients were negative, and 48 patients were under investigation for COVID-19 before surgery. During the same period, 9 patients were diagnosed with COVID-19 without nosocomial infection. CONCLUSIONS: Rescuing patients with SAH and containment of COVID-19 benefit from joint prevention and control, a centralized system of equipment distribution and personnel assignment, and quick workflow establishment.