open access

Vol 55, No 2 (2021)
Short Communication
Submitted: 2020-11-23
Accepted: 2021-02-01
Published online: 2021-03-25
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Effect of COVID-19 pandemic on stroke admissions and quality of stroke interventional treatment in Masovian Voivodeship

Aleksander Dębiec1, Marta Bilik2, Piotr Piasecki3, Adam Stępień1, Jacek Staszewski1
DOI: 10.5603/PJNNS.a2021.0025
·
Pubmed: 33783813
·
Neurol Neurochir Pol 2021;55(2):223-226.
Affiliations
  1. Clinic of Neurology, Military Institute of Medicine, Szaserów 128, 04-141 Warsaw, Poland
  2. Department of Neurology with Stroke Unit, John Paul II Western Hospital, Daleka 11, 05-825 Grodzisk Mazowiecki, Poland
  3. Department of Interventional Radiology, Military Institute of Medicine, Szaserow 128, 04-141 Warsaw, Poland

open access

Vol 55, No 2 (2021)
Short communications
Submitted: 2020-11-23
Accepted: 2021-02-01
Published online: 2021-03-25

Abstract

Aim of study. To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on the pathway of stroke interventional services and major quality indicators of stroke reperfusion therapies in Masovian Voivodeship.

Materials and methods. An exploratory retrospective analysis was performed at two comprehensive stroke centres to assess changes in stroke care between the early phase of the COVID-19 pandemic (weeks 10–18 of 2020) and the same period in 2019.

Results. Of the 419 included stroke patients, 186 (44.4%) presented during the COVID-19 period. There was an increase in in-hospital delays for reperfusion therapies, and a significant decrease in the number of acute cerebrovascular accident admissions, predominantly related to a low number of transient ischaemic attack (TIA) admissions to hospital (-20.17%). The delays were shorter in the mothership paradigm than in the drip-and-ship paradigm of acute stroke care (onset-to-groin 293 vs. 232 min, p = 0.03). No differences in stroke aetiology, large-vessel occlusion frequency, or severe stroke admissions in the COVID-19 period were observed.

Conclusions and clinical implications. COVID-19’s emergence was correlated with a significant reduction in admissions to stroke departments, particularly for TIAs, and a prolonged delay in reperfusion stroke treatment, especially in the drip-and-ship paradigm. An educational campaign to raise public awareness of TIA and/or stroke symptoms and immediate reorganisation of stroke care during the COVID-19 era are necessary.

Abstract

Aim of study. To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on the pathway of stroke interventional services and major quality indicators of stroke reperfusion therapies in Masovian Voivodeship.

Materials and methods. An exploratory retrospective analysis was performed at two comprehensive stroke centres to assess changes in stroke care between the early phase of the COVID-19 pandemic (weeks 10–18 of 2020) and the same period in 2019.

Results. Of the 419 included stroke patients, 186 (44.4%) presented during the COVID-19 period. There was an increase in in-hospital delays for reperfusion therapies, and a significant decrease in the number of acute cerebrovascular accident admissions, predominantly related to a low number of transient ischaemic attack (TIA) admissions to hospital (-20.17%). The delays were shorter in the mothership paradigm than in the drip-and-ship paradigm of acute stroke care (onset-to-groin 293 vs. 232 min, p = 0.03). No differences in stroke aetiology, large-vessel occlusion frequency, or severe stroke admissions in the COVID-19 period were observed.

Conclusions and clinical implications. COVID-19’s emergence was correlated with a significant reduction in admissions to stroke departments, particularly for TIAs, and a prolonged delay in reperfusion stroke treatment, especially in the drip-and-ship paradigm. An educational campaign to raise public awareness of TIA and/or stroke symptoms and immediate reorganisation of stroke care during the COVID-19 era are necessary.

Get Citation

Keywords

stroke, COVID-19, healthcare system, mechanical thrombectomy, stroke quality measures

About this article
Title

Effect of COVID-19 pandemic on stroke admissions and quality of stroke interventional treatment in Masovian Voivodeship

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 55, No 2 (2021)

Article type

Short Communication

Pages

223-226

Published online

2021-03-25

Page views

991

Article views/downloads

362

DOI

10.5603/PJNNS.a2021.0025

Pubmed

33783813

Bibliographic record

Neurol Neurochir Pol 2021;55(2):223-226.

Keywords

stroke
COVID-19
healthcare system
mechanical thrombectomy
stroke quality measures

Authors

Aleksander Dębiec
Marta Bilik
Piotr Piasecki
Adam Stępień
Jacek Staszewski

References (7)
  1. Markus HS, Brainin M. COVID-19 and stroke-A global World Stroke Organization perspective. Int J Stroke. 2020; 15(4): 361–364.
  2. Zhao J, Li H, Kung D, et al. Impact of the COVID-19 Epidemic on Stroke Care and Potential Solutions. Stroke. 2020; 51(7): 1996–2001.
  3. Szmuda T, Ali S, Słoniewski P, et al. Telemedicine in neurosurgery during the novel coronavirus (COVID-19) pandemic. Neurol Neurochir Pol. 2020; 54(2): 207–208.
  4. Liu R, Zhao J, Fisher M. The global impact of COVID-19 on acute stroke care. CNS Neurosci Ther. 2020 [Epub ahead of print].
  5. Słowik A, Nowak R, Popiela T. Significant fall in stroke admissions in the Malopolska Voivodeship of Poland during the COVID-19 pandemic. Neurol Neurochir Pol. 2020; 54(5): 471–472.
  6. Remuzzi A, Remuzzi G. COVID-19 and Italy: what next? The Lancet. 2020; 395(10231): 1225–1228.
  7. Zaka A, Shamloo SE, Fiorente P, et al. COVID-19 pandemic as a watershed moment: A call for systematic psychological health care for frontline medical staff. J Health Psychol. 2020; 25(7): 883–887.

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