Department of Neurosurgery, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, Sichuan 610041, P. R. China.
Department of Neurosurgery, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, Sichuan 610041, P. R. China.
J Stroke Cerebrovasc Dis. 2021 Mar;30(3):105536. doi: 10.1016/j.jstrokecerebrovasdis.2020.105536. Epub 2020 Dec 15.
The coronavirus disease 2019 (COVID-19) pandemic has had a comprehensive impact on healthcare services worldwide. We sought to determine whether COVID-19 affected the treatment and prognosis of hemorrhagic stroke in a regional medical center in mainland China.
Patients with hemorrhagic stroke admitted in the Neurosurgery Department of West China Hospital from January 24, 2020, to March 25, 2020 (COVID-19 period), and from January 24, 2019, to March 25, 2019 (pre-COVID-19 period), were identified. Clinical characteristics, hospital arrival to neurosurgery department arrival time (door-to-department time), reporting rate of pneumonia and 3-month mRS (outcome) were compared.
A total of 224 patients in the pre-COVID-19 period were compared with 126 patients in the COVID-19 period. Milder stroke severity was observed in the COVID-19 period (NIHSS 6 [2-20] vs. 3 [2-15], p = 0.005). The median door-to-department time in the COVID-19 period was approximately 50 minutes longer than that in the pre-COVID-19 period (96.5 [70.3-193.3] vs. 144.5 [93.8-504.5], p = 0.000). A higher rate of pneumonia complications was reported in the COVID-19 period (40.6% vs. 60.7%, p = 0.000). In patients with moderate hemorrhagic stroke, the percentage of good outcomes (mRS < 3) in the pre-COVID-19 period was much higher than that in the COVID-19 period (53.1% vs. 26.3%, p = 0.047).
COVID-19 may have several impacts on the treatment of hemorrhagic stroke and may influence the clinical outcomes of specific patients. Improvements in the treatment process for patients with moderate stroke may help to improve the overall outcome of hemorrhagic stroke during COVID-19.
2019 年冠状病毒病（COVID-19）大流行对全球医疗服务产生了全面影响。我们旨在确定 COVID-19 是否会影响中国大陆地区一家区域医疗中心的出血性脑卒中的治疗和预后。
我们确定了 2020 年 1 月 24 日至 3 月 25 日（COVID-19 期间）和 2019 年 1 月 24 日至 3 月 25 日（COVID-19 之前）期间在华西医院神经外科住院的出血性脑卒中患者。比较了临床特征、从到达医院到进入神经外科的时间（门到科室时间）、肺炎报告率和 3 个月 mRS（结局）。
在 COVID-19 之前的时期，共比较了 224 例患者，在 COVID-19 时期比较了 126 例患者。COVID-19 时期的脑卒中严重程度较轻（NIHSS 6 [2-20] vs. 3 [2-15]，p=0.005）。COVID-19 时期的门到科室时间中位数比 COVID-19 之前的时期长约 50 分钟（96.5 [70.3-193.3] vs. 144.5 [93.8-504.5]，p=0.000）。COVID-19 时期报告的肺炎并发症发生率较高（40.6% vs. 60.7%，p=0.000）。在中度出血性脑卒中患者中，COVID-19 之前时期的良好结局（mRS<3）比例明显高于 COVID-19 时期（53.1% vs. 26.3%，p=0.047）。
COVID-19 可能对出血性脑卒中的治疗产生多种影响，并可能影响特定患者的临床结局。改善中度脑卒中患者的治疗过程可能有助于改善 COVID-19 期间出血性脑卒中的整体结局。
