Your browser doesn't support javascript.
Decline in mild stroke presentations and intravenous thrombolysis during the COVID-19 pandemic: The Society of Vascular and Interventional Neurology Multicenter Collaboration.
Ortega-Gutierrez, Santiago; Farooqui, Mudassir; Zha, Alicia; Czap, Alexandra; Sebaugh, Jacob; Desai, Shashvat; Jadhav, Ashutosh; Vora, Nirav; Rai, Vivek; Jovin, Tudor G; Thon, Jesse M; Heslin, Mark; Thau, Lauren; Zevallos, Cynthia; Quispe-Orozco, Darko; Jillella, Dinesh V; Nahab, Fadi; Mohammaden, Mahmoud H; Nogueira, Raul G; Haussen, Diogo C; Nguyen, Thanh N; Romero, Jose Rafael; Aparicio, Hugo J; Osman, Mohamed; Haq, Israr Ul; Liebeskind, David; Hassan, Ameer E; Zaidat, Osama; Siegler, James E.
  • Ortega-Gutierrez S; Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, 52242, USA. Electronic address: santy-ortega@uiowa.edu.
  • Farooqui M; Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, 52242, USA.
  • Zha A; Institute of Stroke and Cerebrovascular Disease, Department of Neurology, University of Texas McGovern Medical School, Houston TX, 77030, USA.
  • Czap A; Institute of Stroke and Cerebrovascular Disease, Department of Neurology, University of Texas McGovern Medical School, Houston TX, 77030, USA.
  • Sebaugh J; Institute of Stroke and Cerebrovascular Disease, Department of Neurology, University of Texas McGovern Medical School, Houston TX, 77030, USA.
  • Desai S; University of Pittsburgh Medical Center Mercy Hospital, Pittsburgh, PA, 15219, USA; University of Pittsburgh Medical Center Presbyterian Medical Center, Pittsburgh, PA, 15213, USA.
  • Jadhav A; University of Pittsburgh Medical Center Mercy Hospital, Pittsburgh, PA, 15219, USA; University of Pittsburgh Medical Center Presbyterian Medical Center, Pittsburgh, PA, 15213, USA.
  • Vora N; Ohio Health Neuroscience Center, Riverside Methodist Hospital, Columbus, OH, 43214, USA.
  • Rai V; Ohio Health Neuroscience Center, Riverside Methodist Hospital, Columbus, OH, 43214, USA.
  • Jovin TG; Cooper Neurological Institute, Cooper University Hospital, Camden, NJ, 08103, USA.
  • Thon JM; Cooper Neurological Institute, Cooper University Hospital, Camden, NJ, 08103, USA.
  • Heslin M; Cooper Neurological Institute, Cooper University Hospital, Camden, NJ, 08103, USA.
  • Thau L; Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, 52242, USA.
  • Zevallos C; Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, 52242, USA.
  • Quispe-Orozco D; Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, 52242, USA.
  • Jillella DV; Department of Neurology, Emory University School of Medicine, Atlanta, GA, 30322, USA; Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Atlanta, GA, 30303, USA.
  • Nahab F; Department of Neurology & Pediatrics, Emory University, Atlanta, GA, 30319, USA.
  • Mohammaden MH; Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Atlanta, GA, 30303, USA.
  • Nogueira RG; Department of Neurology, Emory University School of Medicine, Atlanta, GA, 30322, USA; Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Atlanta, GA, 30303, USA.
  • Haussen DC; Department of Neurology, Emory University School of Medicine, Atlanta, GA, 30322, USA; Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Atlanta, GA, 30303, USA.
  • Nguyen TN; Department of Neurology, Boston Medical Center, Boston University School of Medicine, MA, 02118, USA.
  • Romero JR; Department of Neurology, Boston Medical Center, Boston University School of Medicine, MA, 02118, USA.
  • Aparicio HJ; Department of Neurology, Boston Medical Center, Boston University School of Medicine, MA, 02118, USA.
  • Osman M; Department of Neurology, Mercy Health St. Vincent Hospital, Toledo, OH, 43608, USA.
  • Haq IU; Department of Neurology, Mercy Health St. Vincent Hospital, Toledo, OH, 43608, USA.
  • Liebeskind D; Department of Neurology, Ronald Reagan University of California at Los Angeles, Los Angeles, CA, 90095, USA.
  • Hassan AE; Department of Neurology, University of Texas Rio Grande Valley, Valley Baptist Medical Center, Harlingen, TX, 78550, USA.
  • Zaidat O; Department of Neurology, Mercy Health St. Vincent Hospital, Toledo, OH, 43608, USA.
  • Siegler JE; Cooper Neurological Institute, Cooper University Hospital, Camden, NJ, 08103, USA.
Clin Neurol Neurosurg ; 201: 106436, 2021 02.
Article in English | MEDLINE | ID: covidwho-1059739
Semantic information from SemMedBD (by NLM)
1. Vascular occlusion CAUSES Cerebrovascular accident
Subject
Vascular occlusion
Predicate
CAUSES
Object
Cerebrovascular accident
2. Acute Ischemic Stroke PROCESS_OF Patients
Subject
Acute Ischemic Stroke
Predicate
PROCESS_OF
Object
Patients
3. Severe disease PROCESS_OF Patients
Subject
Severe disease
Predicate
PROCESS_OF
Object
Patients
4. Vascular occlusion CAUSES Cerebrovascular accident
Subject
Vascular occlusion
Predicate
CAUSES
Object
Cerebrovascular accident
5. Acute Ischemic Stroke PROCESS_OF Patients
Subject
Acute Ischemic Stroke
Predicate
PROCESS_OF
Object
Patients
6. Severe disease PROCESS_OF Patients
Subject
Severe disease
Predicate
PROCESS_OF
Object
Patients
ABSTRACT

BACKGROUND:

To evaluate overall ischemic stroke volumes and rates, specific subtypes, and clinical presentation during the COVID-19 pandemic in a multicenter observational study from eight states across US.

METHODS:

We compared all ischemic strokes admitted between January 2019 and May 2020, grouped as; March-May 2020 (COVID-19 period) and March-May 2019 (seasonal pre-COVID-19 period). Primary outcome was stroke severity at admission measured by NIHSS stratified as mild (0-7), moderate [8-14], and severe (>14). Secondary outcomes were volume of large vessel occlusions (LVOs), stroke etiology, IV-tPA rates, and discharge disposition.

RESULTS:

Of the 7969 patients diagnosed with acute ischemic stroke during the study period, 933 (12 %) presented in the COVID-19 period while 1319 (17 %) presented in the seasonal pre-COVID-19 period. Significant decline was observed in the mean weekly volumes of newly diagnosed ischemic strokes (98 ± 3 vs 50 ± 20,p = 0.003), LVOs (16.5 ± 3.8 vs 8.3 ± 5.9,p = 0.008), and IV-tPA (10.9 ± 3.4 vs 5.3 ± 2.9,p = 0.0047), whereas the mean weekly proportion of LVOs (18 % ±5 vs 16 % ±7,p = 0.24) and IV-tPA (10.4 % ±4.5 vs. 9.9 % ±2.4,p = 0.66) remained the same, when compared to the seasonal pre-COVID-19 period. Additionally, an increased proportion of patients presented with a severe disease (NIHSS > 14) during the COVID-19 period (29.7 % vs 24.5 %,p < 0.025). The odds of being discharged to home were 26 % greater in the COVID-19 period when compared to seasonal pre-COVID-19 period (OR1.26, 95 % CI1.07-1.49,p = 0.016).

CONCLUSIONS:

During COVID-19 period there was a decrease in volume of newly diagnosed ischemic stroke cases and IV-tPA administration. Patients admitted to the hospital had severe neurological clinical presentation and were more likely to discharge home.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Societies, Medical / Thrombolytic Therapy / Stroke / COVID-19 / Neurology Type of study: Controlled clinical trial / Diagnostic study / Etiology study / Incidence study / Observational study / Risk factors Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Clin Neurol Neurosurg Year: 2021 Document Type: Article

Full text: Available Collection: International databases Database: MEDLINE Main subject: Societies, Medical / Thrombolytic Therapy / Stroke / COVID-19 / Neurology Type of study: Controlled clinical trial / Diagnostic study / Etiology study / Incidence study / Observational study / Risk factors Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Clin Neurol Neurosurg Year: 2021 Document Type: Article