Zedde Marialuisa, Pezzella Francesca Romana, Paciaroni Maurizio, Corea Francesco, Reale Nicoletta, Toni Danilo, Caso Valeria
Neurology Unit, Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Stroke Unit, San Camillo Forlanini Hospital, Rome, Italy.
Eur Stroke J. 2020 Sep;5(3):222-229. doi: 10.1177/2396987320942622. Epub 2020 Jul 26.
To analyse structural and non-structural modifications of acute stroke care pathways undertaken at healthcare institutions across the regions of Italy due to the coronavirus disease 2019 (COVID-19) pandemic.
Research on National decrees specific for the pandemic was carried out. The stroke pathways of four Italian regions from North to South, such as Lombardy, Veneto, Lazio and Campania, were analysed before and after the pandemic outbreak.
On 29 February 2020, the Italian Minister of Health issued national guidelines on how to address the COVID-19 emergency. Stroke management was affected and required changes, basically resulting in the need to prioritise the ongoing COVID-19 emergency. In the most affected regions, the closure of departments and hospitals led to a complete reorganisation of previously functioning stroke networks. With the closure of several Stroke Units and Stroke Centres, the transportation time to hospital lengthened significantly, especially for the outlying populations.
The COVID-19 pandemic outbreak has been spreading rapidly in Italy and placing an overwhelming burden on healthcare systems. In response to this, political and healthcare decision-makers worked together to develop and implement efforts to sustain the national healthcare system while fighting the pandemic. Stroke care pathways changed during the pandemic and different organisational models were applied in the most affected regions.
Stroke treatment pathways will need to be redesigned so to guarantee that severe and acute disease patients do not lose their rights to the access and delivery of care during the COVID-19 pandemics.
分析意大利各地区医疗机构因2019年冠状病毒病（COVID-19）大流行而对急性中风护理路径进行的结构和非结构调整。
对针对该大流行的国家法令进行研究。分析了意大利从北到南四个地区（如伦巴第、威尼托、拉齐奥和坎帕尼亚）在大流行爆发前后的中风护理路径。
2020年2月29日，意大利卫生部长发布了关于应对COVID-19紧急情况的国家指南。中风管理受到影响并需要改变，基本上导致需要优先处理持续的COVID-19紧急情况。在受影响最严重的地区，科室和医院的关闭导致先前运作的中风网络完全重组。随着多个中风单元和中风中心的关闭，前往医院的运输时间显著延长，尤其是对于偏远地区的人群。
COVID-19大流行在意大利迅速蔓延，给医疗系统带来了巨大负担。对此，政治和医疗决策者共同努力，在抗击大流行的同时制定并实施维持国家医疗系统的措施。中风护理路径在大流行期间发生了变化，受影响最严重的地区采用了不同的组织模式。
需要重新设计中风治疗路径，以确保在COVID-19大流行期间，重症和急症患者不会失去获得护理和接受治疗的权利。
