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Impact of the COVID‐19 outbreak on acute stroke pathways – insights from the Alsace region in France
Author(s) -
Pop R.,
Quenardelle V.,
Hasiu A.,
Mihoc D.,
Sellal F.,
Dugay M. H.,
Lebedinsky P. A.,
Schluck E.,
LA Porta A.,
Courtois S.,
Gheoca R.,
Wolff V.,
Beaujeux R.
Publication year - 2020
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.14316
Subject(s) - medicine , stroke (engine) , thrombolysis , acute stroke , incidence (geometry) , outbreak , emergency medicine , covid-19 , revascularization , retrospective cohort study , pediatrics , disease , tissue plasminogen activator , myocardial infarction , virology , mechanical engineering , physics , optics , infectious disease (medical specialty) , engineering
Background and purpose To date, no study has attempted to quantify the impact of the COVID‐19 outbreak on the incidence and treatment of acute stroke. Methods This was a retrospective review of acute stroke pathway parameters in all three stroke units in the Alsace region during the first month of the outbreak (1–31 March 2020), using the similar period from 2019 as a comparator. A secondary detailed analysis of all stroke alerts and stroke unit admissions was performed in the centre with the largest case volume. Results Compared to the same period in 2019, in March 2020 there were 39.6% fewer stroke alerts and 33.3% fewer acute revascularization treatments [40.9% less intravenous thrombolysis (IVT) and 27.6% less mechanical thrombectomy (MT)]. No marked variation was observed in the number of stroke unit admissions (−0.6%). The proportion of patients with acute revascularization treatments (IVT or MT) out of the total number of stroke unit admissions was significantly lower in March 2020 (21.3%) compared to 2019 (31.8%), P = 0.034. There were no significant differences in time delays or severity of clinical symptoms for patients treated by IVT or MT, nor in the distribution of final diagnosis amongst stroke alerts and stroke unit admissions. Conclusion These results suggest that the overall incidence of stroke remained the same, but fewer patients presented within the therapeutic time window. Increased public awareness and corrective measures are needed to mitigate the deleterious effects of the COVID‐19 outbreak on acute stroke care.