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Impact of COVID-19 on stroke admissions, treatments, and outcomes at a comprehensive stroke centre in the United Kingdom.
Padmanabhan, Nishita; Natarajan, Indira; Gunston, Rachel; Raseta, Marko; Roffe, Christine.
  • Padmanabhan N; Neurosciences, Royal Stoke University Hospital, Stoke-on-Trent, UK. nishita.padmanabhan@uhnm.nhs.uk.
  • Natarajan I; Faculty of Medicine and Health Sciences, Keele University, Staffordshire, UK. nishita.padmanabhan@uhnm.nhs.uk.
  • Gunston R; Neurosciences, Royal Stoke University Hospital, Stoke-on-Trent, UK.
  • Raseta M; Neurosciences, Royal Stoke University Hospital, Stoke-on-Trent, UK.
  • Roffe C; Statistics and Mathematical Modelling, Department of Molecular Genetics, Erasmus MC, Rotterdam, Netherlands.
Neurol Sci ; 42(1): 15-20, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1064519
ABSTRACT

INTRODUCTION:

The coronavirus disease (COVID-19) pandemic has changed routine clinical practice worldwide with major impacts on the provision of care and treatment for stroke patients.

METHODS:

This retrospective observational study included all patients admitted to the Royal Stoke University Hospital in Stoke-on-Trent, UK, with a stroke or transient ischaemic attack between March 15th and April 14th, 2020 (COVID). Patient demographics, characteristics of the stroke, treatment details and logistics were compared with patients admitted in the corresponding weeks in the year before (2019).

RESULTS:

There was a 39.5% (n = 101 vs n = 167) reduction in admissions in the COVID cohort compared with 2019 with more severe strokes (median National Institutes of Health Stroke Scale (NIHSS) 7 vs 4, p = 0.02), and fewer strokes with no visible acute pathology (21.8 vs 37.1%, p = 0.01) on computed tomography. There was no statistically significant difference in the rates of thrombolysis (10.9 vs 13.2%, p = 0.72) and/or thrombectomy (5.9 vs 4.8%, p = 0.90) and no statistically significant difference in time from stroke onset to arrival at hospital (734 vs 576 min, p = 0.34), door-to-needle time for thrombolysis (54 vs 64 min, p = 0.43) and door-to-thrombectomy time (181 vs 445 min, p = 0.72). Thirty-day mortality was not significantly higher in the COVID year (10.9 vs 8.9%, p = 0.77). None of the 7 stroke patients infected with COVID-19 died.

CONCLUSIONS:

During the COVID-19 pandemic, the number of stroke admissions fell, and stroke severity increased. There was no statistically significant change in the delivery of thrombolysis and mechanical thrombectomy and no increase in mortality.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Admission / Thrombolytic Therapy / Ischemic Attack, Transient / Stroke / Mechanical Thrombolysis / Tertiary Care Centers / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Neurol Sci Journal subject: Neurology Year: 2021 Document Type: Article Affiliation country: S10072-020-04775-x

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Admission / Thrombolytic Therapy / Ischemic Attack, Transient / Stroke / Mechanical Thrombolysis / Tertiary Care Centers / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Neurol Sci Journal subject: Neurology Year: 2021 Document Type: Article Affiliation country: S10072-020-04775-x