Department of Neurosurgery, Medical Faculty of Pelita Harapan University, Lippo Village Tangerang, Neuroscience Centre Siloam Hospital, Lippo Village Tangerang, Indonesia.
Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia.
J Stroke Cerebrovasc Dis. 2020 Nov;29(11):105185. doi: 10.1016/j.jstrokecerebrovasdis.2020.105185. Epub 2020 Jul 22.
This systematic review and meta-analysis aimed to evaluate the impact of the coronavirus disease (COVID-19) pandemic on stroke care, including the number of stroke alerts/codes, number of reperfusions, and number of thrombectomies during the pandemic compared to those during the pre-pandemic period.
A systematic literature search was performed using the PubMed, EuropePMC, and Cochrane Central databases. The data of interest were the number of strokes, reperfusions, and mechanical thrombectomies during the COVID-19 pandemic versus that during the pre-pandemic period (in a historical comparator group over a specified period of same period length).
The study included 59,233 subjects from 9 studies. Meta-analysis showed that the number of stroke alerts during the pandemic was 64% (56-71%) of that during the pre-pandemic period. The number of reperfusion therapies during the pandemic was 69% (61-77%) of that during the pre-pandemic period. Pooled analysis showed that the number of mechanical thrombectomies performed during the pandemic was 78% (75-80%) of that during the pre-pandemic period. The number of mechanical thrombectomies per stroke patient was higher during the pandemic (OR 1.23 [1.12-1.36], p < 0.001; I: 0%, p = 0.845).
This meta-analysis showed that the number of stroke alerts, reperfusions, and mechanical thrombectomies was reduced by 36%, 31%, and 22%, respectively, during the pandemic. However, the number of patients receiving mechanical thrombectomy per stroke increased.
本系统评价和荟萃分析旨在评估新冠疫情对卒中治疗的影响，包括疫情期间与疫情前相比，卒中预警/代码数量、再灌注数量和机械取栓数量。
使用 PubMed、EuropePMC 和 Cochrane Central 数据库进行系统文献检索。感兴趣的数据是新冠疫情期间与疫情前（在同期特定时间段内的历史对照组）相比的卒中、再灌注和机械取栓数量。
研究纳入了来自 9 项研究的 59233 例患者。荟萃分析显示，疫情期间的卒中预警数量是疫情前的 64%（56%-71%）。疫情期间的再灌注治疗数量是疫情前的 69%（61%-77%）。汇总分析显示，疫情期间进行的机械取栓数量是疫情前的 78%（75%-80%）。疫情期间每例卒中患者接受机械取栓的数量更高（OR 1.23 [1.12-1.36]，p<0.001；I²：0%，p=0.845）。
本荟萃分析显示，疫情期间卒中预警、再灌注和机械取栓的数量分别减少了 36%、31%和 22%，但每例卒中患者接受机械取栓的数量增加。
