Department of Neurology, Minhang Hospital, Fudan University, Shanghai, China (J.Z.).
Department of Cerebrovascular Disease, Henan Provincial People's Hospital, Zhengzhou, China (H.L.).
Stroke. 2020 Jul;51(7):1996-2001. doi: 10.1161/STROKEAHA.120.030225. Epub 2020 May 20.
When the coronavirus disease 2019 (COVID-19) outbreak became paramount, medical care for other devastating diseases was negatively impacted. In this study, we investigated the impact of the COVID-19 outbreak on stroke care across China.
Data from the Big Data Observatory Platform for Stroke of China consisting of 280 hospitals across China demonstrated a significant drop in the number of cases of thrombolysis and thrombectomy. We designed a survey to investigate the major changes during the COVID-19 outbreak and potential causes of these changes. The survey was distributed to the leaders of stroke centers in these 280 hospitals.
From the data of Big Data Observatory Platform for Stroke of China, the total number of thrombolysis and thrombectomy cases dropped 26.7% (<0.0001) and 25.3% (<0.0001), respectively, in February 2020 as compared with February 2019. We retrieved 227 valid complete datasets from the 280 stroke centers. Nearly 50% of these hospitals were designated hospitals for COVID-19. The capacity for stroke care was reduced in the majority of the hospitals. Most of the stroke centers stopped or reduced their efforts in stroke education for the public. Hospital admissions related to stroke dropped ≈40%; thrombolysis and thrombectomy cases dropped ≈25%, which is similar to the results from the Big Data Observatory Platform for Stroke of China as compared with the same period in 2019. Many factors contributed to the reduced admissions and prehospital delays; lack of stroke knowledge and proper transportation were significant limiting factors. Patients not coming to the hospital for fear of virus infection was also a likely key factor.
The COVID-19 outbreak impacted stroke care significantly in China, including prehospital and in-hospital care, resulting in a significant drop in admissions, thrombolysis, and thrombectomy. Although many factors contributed, patients not coming to the hospital was probably the major limiting factor. Recommendations based on the data are provided.
当 2019 年冠状病毒病（COVID-19）疫情成为首要问题时，其他毁灭性疾病的医疗服务受到了负面影响。在这项研究中，我们调查了 COVID-19 疫情对中国各地脑卒中治疗的影响。
中国脑卒中大数据观测平台（Big Data Observatory Platform for Stroke of China）的数据来自全国 280 家医院，显示溶栓和取栓的病例数明显减少。我们设计了一项调查，以调查 COVID-19 疫情期间的主要变化及其潜在原因。该调查分发给了这 280 家医院的脑卒中中心的负责人。
从中国脑卒中大数据观测平台（Big Data Observatory Platform for Stroke of China）的数据来看，与 2019 年 2 月相比，2020 年 2 月溶栓和取栓的总病例数分别下降了 26.7%（<0.0001）和 25.3%（<0.0001）。我们从这 280 家脑卒中中心中检索到 227 份有效的完整数据集。其中近 50%的医院是 COVID-19 指定医院。大多数医院的脑卒中治疗能力有所下降。大多数脑卒中中心停止或减少了对公众的脑卒中健康教育。与脑卒中相关的住院人数下降了约 40%；溶栓和取栓病例数下降了约 25%，与 2019 年同期相比，这与中国脑卒中大数据观测平台（Big Data Observatory Platform for Stroke of China）的数据结果相似。许多因素导致了住院人数和院前延迟的减少；缺乏脑卒中知识和适当的交通是显著的限制因素。由于担心病毒感染而不来医院的患者也是一个重要的可能因素。
COVID-19 疫情对中国的脑卒中治疗产生了重大影响，包括院前和院内治疗，导致住院人数、溶栓和取栓治疗显著减少。虽然有许多因素起作用，但患者不来医院可能是主要的限制因素。根据数据提出了相关建议。
