Neurosciences, Royal Stoke University Hospital, Stoke-on-Trent, UK.
Faculty of Medicine and Health Sciences, Keele University, Staffordshire, UK.
Neurol Sci. 2021 Jan;42(1):15-20. doi: 10.1007/s10072-020-04775-x. Epub 2020 Oct 6.
The coronavirus disease (COVID-19) pandemic has changed routine clinical practice worldwide with major impacts on the provision of care and treatment for stroke patients.
This retrospective observational study included all patients admitted to the Royal Stoke University Hospital in Stoke-on-Trent, UK, with a stroke or transient ischaemic attack between March 15th and April 14th, 2020 (COVID). Patient demographics, characteristics of the stroke, treatment details and logistics were compared with patients admitted in the corresponding weeks in the year before (2019).
There was a 39.5% (n = 101 vs n = 167) reduction in admissions in the COVID cohort compared with 2019 with more severe strokes (median National Institutes of Health Stroke Scale (NIHSS) 7 vs 4, p = 0.02), and fewer strokes with no visible acute pathology (21.8 vs 37.1%, p = 0.01) on computed tomography. There was no statistically significant difference in the rates of thrombolysis (10.9 vs 13.2%, p = 0.72) and/or thrombectomy (5.9 vs 4.8%, p = 0.90) and no statistically significant difference in time from stroke onset to arrival at hospital (734 vs 576 min, p = 0.34), door-to-needle time for thrombolysis (54 vs 64 min, p = 0.43) and door-to-thrombectomy time (181 vs 445 min, p = 0.72). Thirty-day mortality was not significantly higher in the COVID year (10.9 vs 8.9%, p = 0.77). None of the 7 stroke patients infected with COVID-19 died.
During the COVID-19 pandemic, the number of stroke admissions fell, and stroke severity increased. There was no statistically significant change in the delivery of thrombolysis and mechanical thrombectomy and no increase in mortality.
冠状病毒病（COVID-19）大流行改变了全球的常规临床实践，对卒中患者的护理和治疗产生了重大影响。
本回顾性观察研究纳入了 2020 年 3 月 15 日至 4 月 14 日（COVID 期间）在英国斯托克顿的皇家斯托克大学医院因卒中或短暂性脑缺血发作而入院的所有患者。将患者的人口统计学、卒中特征、治疗细节和流程与前一年同期（2019 年）入院的患者进行比较。
与 2019 年相比，COVID 组的入院人数减少了 39.5%（n=101 与 n=167），且卒中更严重（中位数国立卫生研究院卒中量表（NIHSS）为 7 分与 4 分，p=0.02），计算机断层扫描（CT）上无明显急性病变的卒中更少（21.8%与 37.1%，p=0.01）。溶栓（10.9%与 13.2%，p=0.72）和/或取栓（5.9%与 4.8%，p=0.90）的比例无统计学差异，卒中发病至入院的时间（734 分钟与 576 分钟，p=0.34）、溶栓的门到针时间（54 分钟与 64 分钟，p=0.43）和取栓的门到栓时间（181 分钟与 445 分钟，p=0.72）也无统计学差异。COVID 年的 30 天死亡率没有显著升高（10.9%与 8.9%，p=0.77）。7 名感染 COVID-19 的卒中患者均未死亡。
在 COVID-19 大流行期间，卒中入院人数减少，卒中严重程度增加。溶栓和机械取栓的实施情况没有统计学差异，死亡率也没有增加。
