The impact of COVID-19 on acute ischemic stroke admissions: Analysis from a community-based tertiary care center.
J Stroke Cerebrovasc Dis
; 29(12): 105344, 2020 Dec.
Artículo
en Inglés
| MEDLINE | ID: covidwho-796051
ABSTRACT
BACKGROUND/OBJECTIVE:
To evaluate the impact of the COVID-19 pandemic on hospital admissions and outcomes in patients admitted with acute ischemic stroke.METHODS:
Single-center retrospective analysis of patients admitted to the hospital with acute ischemic stroke, between December 1st, 2019 and June 30th, 2020. Outcomes were classified as none-to-minimal disability, moderate-to-severe disability, and death based on discharge disposition, and compared between two time periods pre-COVID-19 era (December 1st, 2019 to March 11th, 2020) and COVID-19 era (March 12th to June 30th, 2020). We also performed a comparative trend analysis for the equivalent period between 2019 and 2020.RESULTS:
Five hundred and seventy-five patients with a mean age (years±SD) of 68±16 were admitted from December 1st, 2019 to June 30th, 2020, with a clinical diagnosis of acute ischemic stroke. Of these, 255 (44.3%) patients were admitted during the COVID-19 era. We observed a 22.1% and 39.5% decline in admission for acute ischemic stroke in April and May 2020, respectively. A significantly higher percentage of patients with acute ischemic stroke received intravenous thrombolysis during the COVID-19 era (pâ¯=â¯0.020). In patients with confirmed COVID-19, we found a higher percentage of older men with preexisting comorbidities such as hyperlipidemia, coronary artery disease, and diabetes mellitus but a lower rate of atrial fibrillation. In addition, we found a treatment delay in both intravenous thrombolysis (median 94.5 min versus 38 min) and mechanical thrombectomy (median 244 min versus 86 min) in patients with confirmed COVID-19 infection. There were no differences in patients' disposition including home, short-term, and long-term facility (pâ¯=â¯0.60).CONCLUSIONS:
We observed a reduction of hospital admissions in acute ischemic strokes and some delay in reperfusion therapy during the COVID-19 pandemic. Prospective studies and a larger dataset analysis are warranted.Palabras clave
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Evaluación de Procesos y Resultados en Atención de Salud
/
Terapia Trombolítica
/
Isquemia Encefálica
/
Trombectomía
/
Accidente Cerebrovascular
/
Tiempo de Tratamiento
/
COVID-19
/
Hospitalización
Tipo de estudio:
Estudio de cohorte
/
Estudios diagnósticos
/
Estudio experimental
/
Estudio observacional
/
Estudio pronóstico
Tópicos:
Covid persistente
Límite:
Anciano
/
Femenino
/
Humanos
/
Masculino
/
Middle aged
País/Región como asunto:
America del Norte
Idioma:
Inglés
Revista:
J Stroke Cerebrovasc Dis
Asunto de la revista:
Angiología
/
Cérebro
Año:
2020
Tipo del documento:
Artículo
País de afiliación:
J.jstrokecerebrovasdis.2020.105344
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