Plumereau Cécile, Cho Tae-Hee, Buisson Marielle, Amaz Camille, Cappucci Matteo, Derex Laurent, Ong Elodie, Fontaine Julia, Rascle Lucie, Riva Roberto, Schiavo David, Benhamed Axel, Douplat Marion, Bony Thomas, Tazarourte Karim, Tuttle Célia, Eker Omer Faruk, Berthezène Yves, Ovize Michel, Nighoghossian Norbert, Mechtouff Laura
Emergency Department, Hospices Civils de Lyon, Lyon, France.
Department of Neurology, Stroke Center, Hospices Civils de Lyon, Lyon, France.
J Neurol. 2021 Jul;268(7):2314-2319. doi: 10.1007/s00415-020-10199-6. Epub 2020 Sep 9.
The coronavirus disease 2019 (COVID-19) pandemic would have particularly affected acute stroke care. However, its impact is clearly inherent to the local stroke network conditions. We aimed to assess the impact of COVID-19 pandemic on acute stroke care in the Lyon comprehensive stroke center during this period.
We conducted a prospective data collection of patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT) during the COVID-19 period (from 29/02/2020 to 10/05/2020) and a control period (from 29/02/2019 to 10/05/2019). The volume of reperfusion therapies and pre and intra-hospital delays were compared during both periods.
A total of 208 patients were included. The volume of IVT significantly decreased during the COVID-period [55 (54.5%) vs 74 (69.2%); p = 0.03]. The volume of MT remains stable over the two periods [72 (71.3%) vs 65 (60.8%); p = 0.14], but the door-to-groin puncture time increased in patients transferred for MT (237 [187-339] vs 210 [163-260]; p < 0.01). The daily number of Emergency Medical Dispatch calls considerably increased (1502 [1133-2238] vs 1023 [960-1410]; p < 0.01).
Our study showed a decrease in the volume of IVT, whereas the volume of MT remained stable although intra-hospital delays increased for transferred patients during the COVID-19 pandemic. These results contrast in part with the national surveys and suggest that the impact of the pandemic may depend on local stroke care networks.
2019年冠状病毒病（COVID-19）大流行可能对急性卒中护理产生了特别的影响。然而，其影响显然取决于当地的卒中网络状况。我们旨在评估COVID-19大流行在此期间对里昂综合卒中中心急性卒中护理的影响。
我们对COVID-19期间（2020年2月29日至2020年5月10日）和对照期间（2019年2月29日至2019年5月10日）接受静脉溶栓（IVT）和/或机械取栓（MT）治疗的急性缺血性卒中（AIS）患者进行了前瞻性数据收集。比较了两个时期的再灌注治疗量以及院前和院内延迟时间。
共纳入208例患者。COVID-19期间IVT的治疗量显著下降[55例（54.5%）对74例（69.2%）；p = 0.03]。MT的治疗量在两个时期保持稳定[72例（71.3%）对65例（60.8%）；p = 0.14]，但转至MT治疗的患者从入院到股动脉穿刺的时间增加（237[187 - 339]对210[163 - 260]；p < 0.01）。紧急医疗调度呼叫的每日数量大幅增加（1502[1133 - 2238]对1023[960 - 1410]；p < 0.01）。
我们的研究表明IVT的治疗量有所下降，而MT的治疗量保持稳定，尽管在COVID-19大流行期间转至MT治疗的患者院内延迟时间增加。这些结果与全国性调查部分相反，表明大流行的影响可能取决于当地的卒中护理网络。
