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Risk of contracting SARS-CoV-2 (COVID-19) from hospital admission and the impact of protection efforts on acute stroke treatment.
Greenwood, Jessica; Belnap, Starlie; Dabus, Guilherme; Linfante, Italo; De Los Rios La Rosa, Felipe.
  • Greenwood J; Miami Neuroscience Institute, Baptist Health South Florida, Miami, FL, USA.
  • Belnap S; Miami Neuroscience Institute, Baptist Health South Florida, Miami, FL, USA.
  • Dabus G; Miami Neuroscience Institute, Baptist Health South Florida, Miami, FL, USA.
  • Linfante I; Miami Neuroscience Institute, Baptist Health South Florida, Miami, FL, USA.
  • De Los Rios La Rosa F; Miami Neuroscience Institute, Baptist Health South Florida, Miami, FL, USA. Electronic address: FelipeDL@baptisthealth.net.
Clin Neurol Neurosurg ; 207: 106793, 2021 08.
Article in English | MEDLINE | ID: covidwho-1293656
ABSTRACT

BACKGROUND:

It is unclear how interventions designed to restrict community and in-hospital exposure to the SARS-CoV-2 (COVID-19) virus influenced stroke care for patients seeking acute treatment. Therefore, we aimed to determine how these COVID-19 interventions impacted acute stroke treatment times and to assess the risk of contracting COVID-19 due to their stay in our medical center.

METHODS:

Retrospective, single center, two-phase study evaluating hospital and community trends from 12/2019 - 04/2020 compared to the previous year and pre/post (n = 156/93) intervention implementation. Phase I assessed stroke treatment times, delay to hospital arrival, and witnessed stroke volume. Phase II, a post-implementation telephone survey, assessed risk of developing symptoms or testing positive for COVID-19.

RESULTS:

Stroke volume declined by 29% (p < .05) from April to March compared to the previous year. However, no significant delays in seeking medical care (pre Mdn=112, post Mdn=95, p = .34) was observed. Witnessed stroke volume decreased 11% (p < .001) compared to the pre-implementation group, but no significant delay in IV alteplase (pre Mdn=22 mins; post Mdn=26 mins, p = .08) nor endovascular treatment (pre Mdn=60 mins; post Mdn=80 mins, p = .45) was observed. In Phase II, 63 patients participated, two tested (3%) COVID-19 positive during admission and four (6%) within two weeks of discharge. COVID-19 contraction risk during and after hospitalization remained similar to the general population (RR=1.75, 95%CI 0.79-3.63). Overall results indicated a marked decrease in stroke volume, no significant delays to either seek or provide acute stroke care were evident, and COVID-19 contraction risk was low.

CONCLUSIONS:

Seeking acute stroke medical care outweighs the risk of COVID-19 exposure.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Patient Admission / Stroke / Time-to-Treatment / COVID-19 Subject: Patient Admission / Stroke / Time-to-Treatment / COVID-19 Type of study: Etiology study / Observational study / Risk factors Language: English Journal: Clin Neurol Neurosurg Clinical aspect: Diagnosis / Etiology Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Patient Admission / Stroke / Time-to-Treatment / COVID-19 Subject: Patient Admission / Stroke / Time-to-Treatment / COVID-19 Type of study: Etiology study / Observational study / Risk factors Language: English Journal: Clin Neurol Neurosurg Clinical aspect: Diagnosis / Etiology Year: 2021
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