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Impact of COVID-19 on Acute Stroke Presentation in a Designated COVID-19 Hospital.
Tan, Qing; Liu, Qing-Jun; Fan, Wen-Hui; Du, Xiao-Yan; Wu, Lin; Gong, Hong-Min; Wei, Jing; Zhao, Rui; Lei, Ming; Zhao, Li-Bo.
  • Tan Q; Department of Neurology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.
  • Liu QJ; Chongqing Key Laboratory of Cerebrovascular Disease Research, Chongqing, China.
  • Fan WH; Department of Neurology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.
  • Du XY; Chongqing Key Laboratory of Cerebrovascular Disease Research, Chongqing, China.
  • Wu L; Department of Neurology, Chongqing Ninth People's Hospital, Chongqing, China.
  • Gong HM; Department of Neurology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.
  • Wei J; Chongqing Key Laboratory of Cerebrovascular Disease Research, Chongqing, China.
  • Zhao R; Department of Neurology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.
  • Lei M; Chongqing Key Laboratory of Cerebrovascular Disease Research, Chongqing, China.
  • Zhao LB; Department of Neurology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.
Front Neurol ; 12: 673703, 2021.
Article in English | MEDLINE | ID: covidwho-1441124
ABSTRACT

Objectives:

Thousands of designated COVID-19 hospitals have been set up in China to fight the ongoing COVID-19 pandemic. Anecdotal reports indicate a falling rate of acute stroke diagnoses in these hospitals during the COVID-19 period. We conducted an exploratory single-center analysis to estimate the change in acute stroke presentation at the designated COVID-19 hospitals.

Methods:

This retrospective observational study included all patients admitted to Yongchuan Hospital Affiliated to Chongqing Medical University with acute stroke between January 24 and March 10, 2020. Patient demographics, characteristics of the stroke, treatment details, and clinical outcomes were compared with those of patients admitted in the corresponding period in the year before (2019, "the pre-COVID-19 period"). Subgroup analysis was performed in the ischemic and hemorrhagic stroke groups.

Results:

A total of 110 patients presented with acute stroke symptoms during the COVID-19 pandemic, compared with 173 patients in the pre-COVID-19 period. A higher proportion of stroke patients presented to the hospital via emergency medical services during the pandemic (48.2 vs. 31.8%, p = 0.006). There was a lower proportion of ischemic stroke patients (50.9 vs. 65.3%, p = 0.016) than in the preceding year. There were significantly fewer patients with 90-day modified Rankin Scale score ≥3 in the COVID-19 period compared with the pre-COVID-19 period (17.3 vs. 30.6%, p = 0.012). Among patients with ischemic stroke, the mean time from patient arrival to vessel puncture for emergency endovascular therapy in the COVID-19 period was shorter than that in the pre-COVID-19 period (109.18 ± 71.39 vs. 270.50 ± 161.51 min, p = 0.002). Among patients with hemorrhagic stroke, the rate of emergency surgical operation in the COVID-19 period was higher than that in the pre-COVID-19 period (48.1 vs. 30.0%, p = 0.047). The mean time from patient arrival to emergency surgical operation (15.31 ± 22.89 vs. 51.72 ± 40.47 min, p = 0.002) was shorter in the COVID-19 period than in the pre-COVID-19 period.

Conclusions:

Although fewer acute stroke patients sought medical care in this designated COVID-19 hospital during the COVID-19 pandemic, this type of hospital was more efficient for timely treatment of acute stroke. Recognizing how acute strokes presented in designated COVID-19 hospitals will contribute to appropriate adjustments in strategy for dealing with acute stroke during COVID-19 and future pandemics.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Front Neurol Year: 2021 Document Type: Article Affiliation country: Fneur.2021.673703

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Front Neurol Year: 2021 Document Type: Article Affiliation country: Fneur.2021.673703