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Ann Clin Transl Neurol ; 8(4): 929-937, 2021 04.
Article in English | MEDLINE | ID: covidwho-1092495

ABSTRACT

OBJECTIVE: To review the global impact of the COVID-19 pandemic on stroke care-metrics and report data from a health system in Houston. METHODS: We performed a meta-analysis of the published literature reporting stroke admissions, intracerebral hemorrhage (ICH) cases, number of thrombolysis (tPA) and thrombectomy (MT) cases, and time metrics (door to needle, DTN; and door to groin time, DTG) during the pandemic compared to prepandemic period. Within our hospital system, between January-June 2019 and January-June 2020, we compared the proportion of stroke admissions and door to tPA and MT times. RESULTS: A total of 32,640 stroke admissions from 29 studies were assessed. Compared to prepandemic period, the mean ratio of stroke admissions during the pandemic was 70.78% [95% CI, 65.02%, 76.54%], ICH cases was 83.10% [95% CI, 71.01%, 95.17%], tPA cases was 81.74% [95% CI, 72.33%, 91.16%], and MT cases was 88.63% [95% CI, 74.12%, 103.13%], whereas DTN time was 104.48% [95% CI, 95.52%, 113.44%] and DTG was 104.30% [95% CI, 81.99%, 126.61%]. In Houston, a total of 4808 cases were assessed. There was an initial drop of ~30% in cases at the pandemic onset. Compared to 2019, there was a significant reduction in mild strokes (NIHSS 1-5) [N (%), 891 (43) vs 635 (40), P = 0.02]. There were similar mean (SD) (mins) DTN [44 (17) vs 42 (17), P = 0.14] but significantly prolonged DTG times [94 (15) vs 85 (20), P = 0.005] in 2020. INTERPRETATION: The COVID-19 pandemic led to a global reduction in stroke admissions and treatment interventions and prolonged treatment time metrics.


Subject(s)
COVID-19/epidemiology , COVID-19/therapy , Patient Admission/trends , Stroke/epidemiology , Stroke/therapy , Brain Ischemia/epidemiology , Brain Ischemia/therapy , Fibrinolytic Agents/administration & dosage , Humans , Pandemics , Texas/epidemiology , Thrombectomy/trends , Thrombolytic Therapy/trends
2.
J Stroke Cerebrovasc Dis ; 30(2): 105429, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-899244

ABSTRACT

The current Coronavirus pandemic due to the novel SARS-Cov-2 virus has proven to have systemic and multi-organ involvement with high acuity neurological conditions including acute ischemic strokes. We present a case series of consecutive COVID-19 patients with cerebrovascular disease treated at our institution including 3 cases of cerebral artery dissection including subarachnoid hemorrhage. Knowledge of the varied presentations including dissections will help treating clinicians at the bedside monitor and manage these complications preemptively.


Subject(s)
Aneurysm, Dissecting/mortality , COVID-19/mortality , Hemorrhagic Stroke/mortality , Hospital Mortality , Intensive Care Units , Intracranial Aneurysm/mortality , Ischemic Stroke/mortality , Patient Admission , Adult , Aged , Aged, 80 and over , Aneurysm, Dissecting/diagnosis , Aneurysm, Dissecting/therapy , COVID-19/diagnosis , COVID-19/therapy , Female , Hemorrhagic Stroke/diagnosis , Hemorrhagic Stroke/therapy , Humans , Intracranial Aneurysm/diagnosis , Intracranial Aneurysm/therapy , Ischemic Stroke/diagnosis , Ischemic Stroke/therapy , Male , Middle Aged , New York City/epidemiology , Prospective Studies , Risk Assessment , Risk Factors
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