A meta-analysis of the global impact of the COVID-19 pandemic on stroke care & the Houston Experience.
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.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Patient Admission
/
Stroke
/
COVID-19
Type of study:
Experimental Studies
/
Observational study
/
Reviews
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
Ann Clin Transl Neurol
Year:
2021
Document Type:
Article
Affiliation country:
Acn3.51322
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