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A meta-analysis of the global impact of the COVID-19 pandemic on stroke care & the Houston Experience.
Reddy, Sujan T; Satani, Nikunj; Beauchamp, Jennifer E S; Selvaraj, Sudhakar; Rajan, Suja S; Rahbar, Mohammad H; Tahanan, Amirali; Kim, Sori; Holder, Travis; Jiang, Xiaoqian; Chen, Luyao; Kamal, Haris; Indupuru, Hari Kishan R; Wu, Tzu-Ching; Savitz, Sean I.
  • Reddy ST; Department of Neurology, Mercy Hospital, Fort Smith, Arkansas, USA.
  • Satani N; Institute for Stroke and Cerebrovascular Diseases, McGovern Medical School, University of Texas Health Science Center at Houston, Texas, USA.
  • Beauchamp JES; Institute for Stroke and Cerebrovascular Diseases, McGovern Medical School, University of Texas Health Science Center at Houston, Texas, USA.
  • Selvaraj S; Institute for Stroke and Cerebrovascular Diseases, McGovern Medical School, University of Texas Health Science Center at Houston, Texas, USA.
  • Rajan SS; Cizik School of Nursing at UTHealth Department of Research, Houston, Texas, USA.
  • Rahbar MH; Louis Faillace, MD, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Texas, USA.
  • Tahanan A; Institute for Stroke and Cerebrovascular Diseases, McGovern Medical School, University of Texas Health Science Center at Houston, Texas, USA.
  • Kim S; Department of Management, Policy and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Texas, USA.
  • Holder T; Biostatistics/Epidemiology/Research Design Core, Center for Clinical and Translational Sciences, University of Texas Health Science Center at Houston, Texas, USA.
  • Jiang X; Biostatistics/Epidemiology/Research Design Core, Center for Clinical and Translational Sciences, University of Texas Health Science Center at Houston, Texas, USA.
  • Chen L; Biostatistics/Epidemiology/Research Design Core, Center for Clinical and Translational Sciences, University of Texas Health Science Center at Houston, Texas, USA.
  • Kamal H; Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston, Texas, USA.
  • Indupuru HKR; Texas Medical Center Library, Houston, Texas, USA.
  • Wu TC; Institute for Stroke and Cerebrovascular Diseases, McGovern Medical School, University of Texas Health Science Center at Houston, Texas, USA.
  • Savitz SI; Institute for Stroke and Cerebrovascular Diseases, McGovern Medical School, University of Texas Health Science Center at Houston, Texas, USA.
Ann Clin Transl Neurol ; 8(4): 929-937, 2021 04.
Article in English | MEDLINE | ID: covidwho-1092495
Semantic information from SemMedBD (by NLM)
1. COVID-19 AFFECTS Cerebrovascular accident
Subject
COVID-19
Predicate
AFFECTS
Object
Cerebrovascular accident
2. COVID-19 AFFECTS Cerebrovascular accident
Subject
COVID-19
Predicate
AFFECTS
Object
Cerebrovascular accident
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.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Admission / Stroke / COVID-19 Type of study: Reviews / Systematic review 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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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Admission / Stroke / COVID-19 Type of study: Reviews / Systematic review Limits: Humans Country/Region as subject: North America Language: English Journal: Ann Clin Transl Neurol Year: 2021 Document Type: Article Affiliation country: Acn3.51322