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Global impact of the COVID-19 pandemic on stroke care and intravenous thrombolysis

Nguyen, T.; Qureshi, M.; Martins, S.; Yamagami, H.; Qiu, Z.; Mansour, O.; Czlonkowska, A.; Abdalkader, M.; Sathya, A.; de Sousa, D. A.; Demeestere, J.; Mikulik, R.; Vanacker, P.; Siegler, J.; Korv, J.; Biller, J.; Liang, C.; Sangha, N.; Zha, A.; Czap, A.; Holmstedt, C.; Turan, T.; Grant, C.; Ntaios, G.; Malhotra, K.; Tayal, A.; Loochtan, A.; Mistry, E.; Alexandrov, A.; Huang, D.; Yaghi, S.; Raz, E.; Sheth, S.; Frankel, M.; Lamou, E. G. B.; Aref, H.; Elbassiouny, A.; Hassan, F.; Mustafa, W.; Menecie, T.; Shokri, H.; Roushdy, T.; Sarfo, F. S.; Alabi, T.; Arabambi, B.; Nwazor, E.; Sunmonu, T. A.; Wahab, K. W.; Mohammed, H. H.; Adebayo, P. B.; Riahi, A.; Ben Sassi, S.; Gwaunza, L.; Rahman, A.; Ai, Z. B.; Bai, F. H.; Duan, Z. H.; Hao, Y. G.; Huang, W. G.; Li, G. W.; Li, W.; Liu, G. Z.; Luo, J.; Shang, X. J.; Sui, Y.; Tian, L.; Wen, H. B.; Wu, B.; Yan, Y. Y.; Yuan, Z. Z.; Zhang, H.; Zhang, J.; Zhao, W. L.; Zi, W. J.; Leung, T. K.; Sahakyan, D.; Chugh, C.; Huded, V.; Menon, B.; Pandian, J.; Sylaja, P. N.; Usman, F. S.; Farhoudi, M.; Sadeghi-Hokmabadi, E.; Reznik, A.; Sivan-Hoffman, R.; Horev, A.; Ohara, N.; Sakai, N.; Watanabe, D.; Yamamoto, R.; Doijiri, R.; Tokuda, N.; Yamada, T.; Terasaki, T.; Yazawa, Y.; Uwatoko, T.; Dembo, T.; Shimizu, H.; Sugiura, Y.; Miyashita, F.; Fukuda, H.; Miyake, K.; Shimbo, J.; Sugimura, Y.; Yagita, Y.; Takenobu, Y.; Matsumaru, Y.; Yamada, S.; Kono, R.; Kanamaru, T.; Yamazaki, H.; Sakaguchi, M.; Todo, K.; Yamamoto, N.; Sonodda, K.; Yoshida, T.; Hashimoto, H.; Nakahara, I.; Faizullina, K.; Kamenova, S.; Kondybayeva, A.; Zhanuzakov, M.; Baek, J. H.; Hwang, Y.; Lee, S. B.; Moon, J.; Park, H.; Seo, J. H.; Seo, K. D.; Young, C. J.; Ahdab, R.; Aziz, Z. A.; Zaidi, W. A. W.; Bin Basri, H.; Chung, L. W.; Husin, M.; Ibrahim, A. B.; Ibrahim, K. A.; Looi, I.; Tan, W. Y.; Yahya, Wnnw, Groppa, S.; Leahu, P.; Al Hashmi, A.; Imam, Y. Z.; Akhtar, N.; Oliver, C.; Kandyba, D.; Alhazzani, A.; Al-Jehani, H.; Tham, C. H.; Mamauag, M. J.; Narayanaswamy, R.; Chen, C. H.; Tang, S. C.; Churojana, A.; Aykac, O.; Ozdemir, A. O.; Hussain, S. I.; John, S.; Vu, H. L.; Tran, A. D.; Nguyen, H. H.; Thong, P. N.; Nguyen, T.; Nguyen, T.; Gattringer, T.; Enzinger, C.; Killer-Oberpfalzer, M.; Bellante, F.; De Blauwe, S.; Van Hooren, G.; De Raedt, S.; Dusart, A.; Ligot, N.; Rutgers, M.; Yperzeele, L.; Alexiev, F.; Sakelarova, T.; Bedekovic, M. R.; Budincevic, H.; Cindric, I.; Hucika, Z.; Ozretic, D.; Saric, M. S.; Pfeifer, F.; Karpowicz, I.; Cernik, D.; Sramek, M.; Skoda, M.; Hlavacova, H.; Klecka, L.; Koutny, M.; Vaclavik, D.; Skoda, O.; Fiksa, J.; Hanelova, K.; Nevsimalova, M.; Rezek, R.; Prochazka, P.; Krejstova, G.; Neumann, J.; Vachova, M.; Brzezanski, H.; Hlinovsky, D.; Tenora, D.; Jura, R.; Jurak, L.; Novak, J.; Novak, A.; Topinka, Z.; Fibrich, P.; Sobolova, H.; Volny, O.; Christensen, H. K.; Drenck, N.; Iversen, H.; Simonsen, C.; Truelsen, T.; Wienecke, T.; Vibo, R.; Gross-Paju, K.; Toomsoo, T.; Antsov, K.; Caparros, F.; Cordonnier, C.; Dan, M.; Faucheux, J. M.; Mechtouff, L.; Eker, O.; Lesaine, E.; Ondze, B.; Pico, F.; Pop, R.; Rouanet, F.; Gubeladze, T.; Khinikadze, M.; Lobjanidze, N.; Tsiskaridze, A.; Nagel, S.; Ringleb, P. A.; Rosenkranz, M.; Schmidt, H.; Sedghi, A.; Siepmann, T.; Szabo, K.; Thomalla, G.; Palaiodimou, L.; Sagris, D.; Kargiotis, O.; Kaliaev, A.; Liebeskind, D.; Hassan, A.; Ranta, A.; Devlin, T.; Zaidat, O.; Castonguay, A.; Jovin, T.; Tsivgoulis, G.; Malik, A.; Ma, A.; Campbell, B.; Kleinig, T.; Wu, T.; Gongora, F.; Lavados, P.; Olavarria, V.; Lereis, V. P.; Corredor, A.; Barbosa, D. M.; Bayona, H.; Barrientos, J. D.; Patino, M.; Thijs, V.; Pirson, A.; Kristoffersen, E. S.; Patrik, M.; Fischer, U.; Bernava, G.; Renieri, L.; Strambo, D.; Ayo-Martin, O.; Montaner, J.; Karlinski, M.; Cruz-Culebras, A.; Luchowski, P.; Krastev, G.; Arenillas, J.; Gralla, J.; Mangiafico, S.; Blasco, J.; Fonseca, L.; Silva, M. L.; Kwan, J.; Banerjee, S.; Sangalli, D.; Frisullo, G.; Yavagal, D.; Uyttenboogaart, M.; Bandini, F.; Adami, A.; de Lecina, M. A.; Arribas, M. A. T.; Ferreira, P.; Cruz, V. T.; Nunes, A. P.; Marto, J. P.; Rodrigues, M.; Melo, T.; Saposnik, G.; Scott, C. A.; Shuaib, A.; Khosravani, H.; Fields, T.; Shoamanesh, A.; Catanese, L.; Mackey, A.; Hill, M.; Etherton, M.; Rost, N.; Lutsep, H.; Lee, V.; Mehta, B.; Pikula, A.; Simmons, M.; Macdougall, L.; Silver, B.; Khandelwal, P.; Morris, J.; Novakovic-White, R.; Ramakrishnan, P.; Shah, R.; Altschul, D.; Almufti, F.; Amaya, P.; Ordonez, C. E. R.; Lara, O.; Kadota, L. R.; Rivera, L. I. P.; Novarro, N.; Escobar, L. D.; Melgarejo, D.; Cardozo, A.; Blanco, A.; Zelaya, J. A.; Luraschi, A.; Gonzalez, V. H. N.; Almeida, J.; Conforto, A.; Almeida, M. S.; Silva, L. D.; Cuervo, D. L. M.; Zetola, V. F.; Martins, R. T.; Valler, L.; Giacomini, L. V.; Cardoso, F. B.; Sahathevan, R.; Hair, C.; Hankey, G.; Salazar, D.; Lima, F. O.; Mont'Alverne, F.; Moises, D.; Iman, B.; Magalhaes, P.; Longo, A.; Rebello, L.; Falup-Pecurariu, C.; Mazya, M.; Wisniewska, A.; Fryze, W.; Kazmierski, R.; Wisniewska, M.; Horoch, E.; Sienkiewicz-Jarosz, H.; Fudala, M.; Rogoziewicz, M.; Brola, W.; Sobolewski, P.; Kaczorowski, R.; Stepien, A.; Klivenyi, P.; Szapary, L.; van den Wijngaard, I.; Demchuk, A.; Abraham, M.; Alvarado-Ortiz, T.; Kaushal, R.; Ortega-Gutierrez, S.; Farooqui, M.; Bach, I.; Badruddin, A.; Barazangi, N.; Nguyen, C.; Brereton, C.; Choi, J. H.; Dharmadhikari, S.; Desai, K.; Doss, V.; Edgell, R.; Linares, G.; Frei, D.; Chaturvedi, S.; Gandhi, D.; Chaudhry, S.; Choe, H.; Grigoryan, M.; Gupta, R.; Helenius, J.; Voetsch, B.; Khwaja, A.; Khoury, N.; Kim, B. S.; Kleindorfer, D.; McDermott, M.; Koyfman, F.; Leung, L.; Linfante, I.; Male, S.; Masoud, H.; Min, J. Y.; Mittal, M.; Multani, S.; Nahab, F.; Nalleballe, K.; Rahangdale, R.; Rafael, J.; Rothstein, A.; Ruland, S.; Sharma, M.; Singh, A.; Starosciak, A.; Strasser, S.; Szeder, V.; Teleb, M.; Tsai, J.; Mohammaden, M.; Pineda-Franks, C.; Asyraf, W.; Nguyen, T. Q.; Tarkanyi, G.; Horev, A.; Haussen, D.; Balaguera, O.; Vasquez, A. R.; Nogueira, R..

Neurology ; 96(15):42, 2021.

文章在英语 | Web of Science | ID: covidwho-1576349

Global impact of the COVID-19 pandemic on stroke care and intravenous thrombolysis

Nguyen, T.; Qureshi, M.; Martins, S.; Yamagami, H.; Qiu, Z.; Mansour, O.; Czlonkowska, A.; Abdalkader, M.; Sathya, A.; Sousa, D. A.; Demeester, J.; Mikulik, R.; Vanacker, P.; Siegler, J.; Korv, J.; Biller, J.; Liang, C.; Sangha, N.; Zha, A.; Czap, A.; Holmstedt, C.; Turan, T.; Grant, C.; Ntaios, G.; Malhotra, K.; Tayal, A.; Loochtan, A.; Mistry, E.; Alexandrov, A.; Huang, D.; Yaghi, S.; Raz, E.; Sheth, S.; Frankel, M.; Lamou, E. G. B.; Aref, H.; Elbassiouny, A.; Hassan, F.; Mustafa, W.; Menecie, T.; Shokri, H.; Roushdy, T.; Sarfo, F. S.; Alabi, T.; Arabambi, B.; Nwazor, E.; Sunmonu, T. A.; Wahab, K. W.; Mohammed, H. H.; Adebayo, P. B.; Riahi, A.; Sassi, S. B.; Gwaunza, L.; Rahman, A.; Ai, Z.; Bai, F.; Duan, Z.; Hao, Y.; Huang, W.; Li, G.; Li, W.; Liu, G.; Luo, J.; Shang, X.; Sui, Y.; Tian, L.; Wen, H.; Wu, B.; Yan, Y.; Yuan, Z.; Zhang, H.; Zhang, J.; Zhao, W.; Zi, W.; Leung, T. K.; Sahakyan, D.; Chugh, C.; Huded, V.; Menon, B.; Pandian, J.; Sylaja, P. N.; Usman, F. S.; Farhoudi, M.; Sadeghi-Hokmabadi, E.; Reznik, A.; Sivan-Hoffman, R.; Horev, A.; Ohara, N.; Sakai, N.; Watanabe, D.; Yamamoto, R.; Doijiri, R.; Kuda, N.; Yamada, T.; Terasaki, T.; Yazawa, Y.; Uwatoko, T.; Dembo, T.; Shimizu, H.; Sugiura, Y.; Miyashita, F.; Fukuda, H.; Miyake, K.; Shimbo, J.; Sugimura, Y.; Yagita, Y.; Takenobu, Y.; Matsumaru, Y.; Yamada, S.; Kono, R.; Kanamaru, T.; Yamazaki, H.; Sakaguchi, M.; Todo, K.; Yamamoto, N.; Sonodda, K.; Yoshida, T.; Hashimoto, H.; Nakahara, I.; Faizullina, K.; Kamenova, S.; Kondybayev, A.; Zhanuzakov, M.; Baek, J. H.; Hwang, Y.; Lee, S. B.; Moon, J.; Park, H.; Seo, J. H.; Seo, K. D.; Young, C. J.; Ahdab, R.; Aziz, Z. A.; Zaidi, W. A. W.; Basr, H. B.; Chung, L. W.; Husin, M.; Ibrahim, A. B.; Ibrahim, K. A.; Looi, I.; Tan, W. Y.; Yahya, W. N. W.; Groppa, S.; Leahu, P.; Hashmi, A. A.; Imam, Y. Z.; Akhtar, N.; Oliver, C.; Kandyba, D.; Alhazzani, A.; Al-Jehani, H.; Tham, C. H.; Mamauag, M. J.; Narayanaswamy, R.; Chen, C. H.; Tang, S. C.; Churojana, A.; Aykaç, O.; Özdemir, A.; Hussain, S. I.; John, S.; Vu, H. L.; Tran, A. D.; Nguyen, H. H.; Thong, P. N.; Nguyen, T.; Nguyen, T.; Gattringer, T.; Enzinger, C.; Killer-Oberpfalzer, M.; Bellante, F.; Deblauwe, S.; Hooren, G. V.; Raedt, S. D.; Dusart, A.; Ligot, N.; Rutgers, M.; Yperzeele, L.; Alexiev, F.; Sakelarova, T.; Bedekovic, M.; Budincevic, H.; Cindric, I.; Hucika, Z.; Ozretic, D.; Saric, M. S.; Pfeifer, F.; Karpowicz, I.; Cernik, D.; Sramek, M.; Skoda, M.; Hlavacova, H.; Klecka, L.; Koutny, M.; Skoda, O.; Fiksa, J.; Hanelova, K.; Nevsimalova, M.; Rezek, R.; Prochazka, P.; Krejstova, G.; Neumann, J.; Vachova, M.; Brzezanski, H.; Hlinovsky, D.; Tenora, D.; Jura, R.; Jurak, L.; Novak, J.; Novak, A.; Topinka, Z.; Fibrich, P.; Sobolova, H.; Volny, O.; Christensen, H. K.; Drenck, N.; Iversen, H.; Simonsen, C.; Truelsen, T.; Wienecke, T.; Vibo, R.; Gross-Paju, K.; Toomsoo, T.; Antsov, K.; Caparros, F.; Cordonnier, C.; Dan, M.; Faucheux, J. M.; Mechtouff, L.; Eker, O.; Lesaine, E.; Pico, F.; Pop, R.; Rouanet, F.; Gubeladze, T.; Khinikadze, M.; Lobjanidze, N.; Tsiskaridze, A.; Nagel, S.; Arthurringleb, P.; Rosenkranz, M.; Schmidt, H.; Sedghi, A.; Siepmann, T.; Szabo, K.; Thomalla, G.; Palaiodimou, L.; Sagris, D.; Kargiotis, O.; Kaliaev, A.; Liebeskind, D.; Hassan, A.; Ranta, A.; Devlin, T.; Zaidat, O.; Castonguay, A.; Jovin, T.; Tsivgoulis, G.; Malik, A.; Ma, A.; Campbel, B.; Kleinig, T.; Wu, T.; Gongora, F.; Lavados, P.; Olavarria, V.; Lereis, V. P.; Corredor, A.; Barbosa, D. M.; Bayona, H.; Barrientos, J. D.; Patino, M.; Thijs, V.; Pirson, A.; Kristoffersen, E. S.; Patrik, M.; Fischer, U.; Bernava, G.; Renieri, L.; Strambo, D.; Ayo-Martin, O.; Montaner, J.; Karlinski, M.; Cruz-Culebras, A.; Luchowski, P.; Krastev, G.; Arenillas, J.; Gralla, J.; Mangiafico, S.; Blasco, J.; Fonseca, L.; Silva, M. L.; Kwan, J.; Banerjee, S.; Sangalli, D.; Frisullo, G.; Yavagal, D.; Uyttenboogaart, M.; Bandini, F.; Adami, A.; Lecina, M. A. D.; Arribas, M. A. T.; Ferreira, P.; Cruz, V. T.; Nunes, A. P.; Marto, J. P.; Rodrigues, M.; Melo, T.; Saposnik, G.; Scott, C. A.; Shuaib, A.; Khosravani, H.; Fields, T.; Shoamanesh, A.; Catanese, L.; MacKey, A.; Hill, M.; Etherton, M.; Rost, N.; Lutsep, H.; Lee, V.; Mehta, B.; Pikula, A.; Simmons, M.; MacDougall, L.; Silver, B.; Khandelwal, P.; Morris, J.; Novakovic-White, R.; Shah, R.; Altschul, D.; Almufti, F.; Amaya, P.; Ordonez, C. E. R.; Lara, O.; Kadota, L. R.; Rivera, L. I.; Novarro, N.; Escobar, L. D.; Melgarejo, D.; Cardozo, A.; Blanco, A.; Zelaya, J. A.; Luraschi, A.; Gonzalez, V. H.; Almeida, J.; Conforto, A.; Almeida, M. S.; Silva, L. D. D.; Cuervo, D. L. M.; Zetola, V. F.; Martins, R. T.; Valler, L.; Giacomini, L. V.; Buchdidcardoso, F.; Sahathevan, R.; Hair, C.; Hankey, G.; Salazar, D.; Lima, F. O.; Mont'alverne, F.; Iman, D. M. B.; Longo, A.; Rebello, L.; Falup-Pecurariu, C.; Mazya, M.; Wisniewska, A.; Fryze, W.; Kazmierski, R.; Wisniewska, M.; Horoch, E.; Sienkiewicz-Jarosz, H.; Fudala, M.; Goziewicz, M.; Brola, W.; Sobolewski, P.; Kaczorowski, R.; Stepien, A.; Klivenyi, P.; Szapary, L.; Wijngaard, I. V. D.; Demchuk, A.; Abraham, M.; Alvarado-Ortiz, T.; Kaushal, R.; Ortega-Gutierrez, S.; Farooqui, M.; Bach, I.; Badruddin, A.; Barazangi, N.; Nguyen, C.; Brereton, C.; Choi, J. H.; Dharmadhikari, S.; Desai, K.; Doss, V.; Edgell, R.; Linares, G.; Frei, D.; Chaturvedi, S.; Gandhi, D.; Chaudhry, S.; Choe, H.; Grigoryan, M.; Gupta, R.; Helenius, J.; Voetsch, B.; Khwaja, A.; Khoury, N.; Kim, B. S.; Kleindorfer, D.; McDermott, M.; Koyfman, F.; Leung, L.; Linfante, I.; Male, S.; Masoud, H.; Min, J.; Mittal, M.; Multani, S.; Nahab, F.; Nalleballe, K.; Rahangdale, R.; Rafael, J.; Rothstein, A.; Ruland, S.; Sharma, M.; Singh, A.; Starosciak, A.; Strasser, S.; Szeder, V.; Teleb, M.; Tsai, J.; Mohammaden, M.; Pineda-Franks, C.; Asyraf, W.; Nguyen, T. Q.; Tarkanyi, A.; Haussen, D.; Balaguera, O.; Rodriguezvasquez, A.; Nogueira, R..

Neurology ; 96(15 SUPPL 1), 2021.

文章在英语 | EMBASE | ID: covidwho-1407898

摘要

Objective: The objectives of this study were to measure the global impact of the pandemic on the volumes for intravenous thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with two control 4-month periods. Background: The COVID-19 pandemic led to widespread repercussions on the delivery of health care worldwide. Design/Methods: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by ICD-10 codes and/or classifications in stroke center databases. Results: There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95%CI,-11.7 to-11.3, p<0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95%CI,-13.8 to-12.7, p<0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95%CI,-13.7 to-10.3, p=0.001). There were greater declines in primary compared to comprehensive stroke centers (CSC) for stroke hospitalizations (-17.3% vs-10.3%, p<0.0001) and IVT (-15.5% vs-12.6%, p=0.0001). Recovery of stroke hospitalization volume (9.5%, 95%CI 9.2-9.8, p<0.0001) was noted over the two later (May, June) versus the two earlier (March, April) months of the pandemic, with greater recovery in hospitals with lower COVID-19 hospitalization volume, high volume stroke center, and CSC. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. SARS-CoV-2 infection was noted in 3.3% (1,722/52,026) of all stroke admissions. Conclusions: The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months, with greater recovery in hospitals with lower COVID-19 hospitalizations, high volume stroke centers, and CSCs.

Worse discharge outcomes of stroke patients during the COVID-19 pandemic: A dual-network experience

Cummings, C.; Almallouhi, E.; Al Kasab, S.; Barnes, H.; Shah, M.; Giurgiutiu, D. V.; Switzer, J. A.; Holmstedt, C. A..

Stroke ; 52(SUPPL 1), 2021.

文章在英语 | EMBASE | ID: covidwho-1234385

摘要

Background and Purpose: The novel coronavirus of 2019 (COVID-19) has been associated with worse outcomes for hospitalized patients across the US and worldwide. Our study investigates the effect of the pandemic on functional outcomes for patients presenting with stroke-like symptoms in two high-volume Tele-Stroke networks. Methods: We performed retrospective chart review of 7689 consecutive patients seen through two Tele-Stroke networks (Medical University of South Carolina and Augusta University) from July 2019 through May 2020. Discharge outcomes were assessed using modified Rankin scale (mRS). We dichotomized patients to preCOVID-19 pandemic (July 2019 to February 2020) and during COVID- 19 pandemic (March to May 2020). Results: During COVID, a higher percentage of patients received intravenous tissue plasminogen activator (tPA) (14.2% vs 11.3% before, p=0.001), despite a similar baseline NIHSS. Also, patients during the pandemic had a shorter symptom-onset to hospital door time (288 vs 353, P=0.012). Demographics were similar between groups, other than older age in patients presenting during COVID (66.02 vs 65.15 before, p=0.04) (table 1). During the pandemic, a higher percentage of patients had a poor functional outcome, as defined by mRS 3-6 (35.7% vs 30% before, p=0.012), and a higher percentage died or were discharged to hospice (7.0% vs 5.1%, p=0.000). Conclusions: Despite earlier ED presentation and increased tPA administration, our results demonstrate worse discharge outcomes during the pandemic in two large telestroke networks. Changes in workflow and resulting delays during COVID-19 may explain these findings.

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