RESUMO
Background: The COVID-19 epidemic is still continuing. Little is known about the effects on stroke care. This study aims to investigate the impact of COVID-19 epidemic on urgent stroke treatment in a tertiary stroke center in western China, and to provide reference points for stroke treatment strategies during public health emergencies. Methods: The retrospective, population-based study was conducted in West China Hospital of Sichuan University, the largest hospital in the southwest of China in COVID-19 period (Dec 1, 2019 to Mar 11, 2020) and baseline non-COVID-19 period (Dec 1, 2018 to Mar 11, 2019). The COVID-19 period was further divided into pre- and peak-epidemic stages defined using government data. Medical practice was strictly based on hospital contingency plans and national expert consensus. We compared emergency visits and efficiency of stroke treatment for the baseline and COVID-19 periods. A subgroup analysis was then conducted between pre-and peak-epidemic stages. Findings: Compared with the baseline data, we found no differences in time to deliver acute interventions, intravenous thrombolysis rate (IVT), and neurological improvements in the whole COVID-19 period. There were significant reductions in visits (38·9%, p<0·0001), admission within six hours from onset (13·2%, p=0·001), mild stroke admissions (15·3%, p=0·006) and increases in rates of mechanical thrombectomy (24·4%, p<0·0001) and excellent outcome (18·1%, p<0·01). We observed significantly higher rate of IVT (17·1%, p=0·04) and shorter time to computed tomography scan (22%, p=0·01), during the peak-epidemic stages in subgroup analysis. Interpretation: The hospital’s capacity to deliver high quality stroke emergency care was hardly be affected as a result of comprehensive measures being implemented.The results provide some key messages for the practice of stroke emergency care during a crisis. Funding Statement: National Key R&D Program of China (2018YFC1311400 and 2018YFC1311401).Declaration of Interests: Authors declare no competing interests.Ethics Approval Statement: The study and analysis plan was approved by the ethical review board in West China Hospital of Sichuan University (2019/319). Written informed consent was waived.