Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Neurology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Neurol Sci. 2022 Jul;43(7):4061-4068. doi: 10.1007/s10072-022-06018-7. Epub 2022 Mar 25.
It has been reported that acute stroke services were compromised during COVID-19 due to various pandemic-related issues. We aimed to investigate these changes by recruiting centers from different countries.
Eight countries participated in this cross-sectional, observational, retrospective study by providing data from their stroke data base. We compared 1 year before to 1 year during COVID-19 as regards onset to door (OTD), door to needle (DTN), door to groin (DTG), duration of hospital stay, National Institute of Health Stroke Scale (NIHSS) at baseline, 24 h, and at discharge as well as modified Rankin score (mRS) on discharge and at 3 months follow-up.
During the pandemic year, there was a reduction in the number of patients, median age was significantly lower, admission NIHSS was higher, hemorrhagic stroke increased, and OTD and DTG showed no difference, while DTN time was longer, rtPA administration was decreased, thrombectomy was more frequent, and hospital stay was shorter. mRS was less favorable on discharge and at 3 months.
COVID-19 showed variable effects on stroke services. Some were negatively impacted as the number of patients presenting to hospitals, DTN time, and stroke outcome, while others were marginally affected as the type of management.
据报道,由于与大流行相关的各种问题,急性脑卒中服务在 COVID-19 期间受到影响。我们旨在通过招募来自不同国家的中心来调查这些变化。
八个国家通过提供其脑卒中数据库的数据参与了这项横断面、观察性、回顾性研究。我们比较了 COVID-19 前 1 年和大流行期间的情况,包括发病至到院(OTD)、到院至溶栓(DTN)、到院至穿刺(DTG)、住院时间、基线、24 小时和出院时的国立卫生研究院脑卒中量表(NIHSS)评分以及出院时和 3 个月随访时的改良 Rankin 量表(mRS)评分。
在大流行期间,患者数量减少,中位年龄明显降低,入院 NIHSS 评分升高,出血性脑卒中增加,而 OTD 和 DTG 无差异,而 DTN 时间延长,rtPA 给药减少,血栓切除术更频繁,住院时间缩短。出院时和 3 个月时的 mRS 评分更差。
COVID-19 对脑卒中服务产生了不同的影响。一些方面受到了负面影响,如就诊患者数量、DTN 时间和脑卒中结局,而其他方面则受到了轻微影响,如管理方式。