Impact of the COVID-19 Pandemic on Acute Ischemic Stroke Presentation, Treatment, and Outcomes
Introduction. The World Health Organization declared COVID-19 a global pandemic last year. While a clear impact of COVID-19 on the declining stroke volume has been reported, its overall impact on stroke presentation and clinical outcomes has not been established. The purpose of this study was to ass...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-01-01
|
| Series: | Stroke Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2021/8653396 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832546195283640320 |
|---|---|
| author | Timothy G. White Gabriela Martinez Jason Wang Michele Gribko Artem Boltyenkov Rohan Arora Jeffrey M. Katz Henry H. Woo Pina C. Sanelli |
| author_facet | Timothy G. White Gabriela Martinez Jason Wang Michele Gribko Artem Boltyenkov Rohan Arora Jeffrey M. Katz Henry H. Woo Pina C. Sanelli |
| author_sort | Timothy G. White |
| collection | DOAJ |
| description | Introduction. The World Health Organization declared COVID-19 a global pandemic last year. While a clear impact of COVID-19 on the declining stroke volume has been reported, its overall impact on stroke presentation and clinical outcomes has not been established. The purpose of this study was to assess the impact of COVID-19 on acute ischemic stroke volume, presentation, treatment, and outcomes at comprehensive stroke centers. Methods. A retrospective review of patients with a discharge diagnosis of acute ischemic stroke from the Get With The Guidelines database was performed from January 1, 2019, to July 1, 2020. The following time periods were defined: Pre-COVID (January/February), Peak-COVID (March/April), and Post-COVID (May/June). Bivariate analyses were performed comparing the 2020 and 2019 time periods to determine differences in stroke volume, presentation, treatment, and outcomes. Results. Stroke volumes were significantly lower during the Peak-COVID period in 2020 compared to that in 2019, with an absolute decline of 49.5% (P<0.001). Patients were more likely to present after 24 hours from last known well during the 2020 Peak-COVID period (P=0.03). However, there was not a significant difference in the rate of treatment with either the tissue plasminogen activator (tPA) or mechanical thrombectomy during the Peak-COVID period. Interestingly, relative treatment rates increased during the 2020 Post-COVID period to 11.4% (P=0.01). Conclusions. The overall ischemic stroke volume decreased during the pandemic, and patients had a tendency to present later, beyond eligible treatment windows. However, rates of treatment, patient demographics, and stroke outcomes did not significantly change when compared to the prior year. |
| format | Article |
| id | doaj-art-5928e1139e4e4c40a5fdeb9975ffabb4 |
| institution | Kabale University |
| issn | 2090-8105 2042-0056 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke Research and Treatment |
| spelling | doaj-art-5928e1139e4e4c40a5fdeb9975ffabb42025-02-03T07:23:31ZengWileyStroke Research and Treatment2090-81052042-00562021-01-01202110.1155/2021/86533968653396Impact of the COVID-19 Pandemic on Acute Ischemic Stroke Presentation, Treatment, and OutcomesTimothy G. White0Gabriela Martinez1Jason Wang2Michele Gribko3Artem Boltyenkov4Rohan Arora5Jeffrey M. Katz6Henry H. Woo7Pina C. Sanelli8Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, USACenter of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Manhasset, NY, USACenter of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Manhasset, NY, USADepartment of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, USACenter of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Manhasset, NY, USADepartment of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, USADepartment of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, USADepartment of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, USACenter of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Manhasset, NY, USAIntroduction. The World Health Organization declared COVID-19 a global pandemic last year. While a clear impact of COVID-19 on the declining stroke volume has been reported, its overall impact on stroke presentation and clinical outcomes has not been established. The purpose of this study was to assess the impact of COVID-19 on acute ischemic stroke volume, presentation, treatment, and outcomes at comprehensive stroke centers. Methods. A retrospective review of patients with a discharge diagnosis of acute ischemic stroke from the Get With The Guidelines database was performed from January 1, 2019, to July 1, 2020. The following time periods were defined: Pre-COVID (January/February), Peak-COVID (March/April), and Post-COVID (May/June). Bivariate analyses were performed comparing the 2020 and 2019 time periods to determine differences in stroke volume, presentation, treatment, and outcomes. Results. Stroke volumes were significantly lower during the Peak-COVID period in 2020 compared to that in 2019, with an absolute decline of 49.5% (P<0.001). Patients were more likely to present after 24 hours from last known well during the 2020 Peak-COVID period (P=0.03). However, there was not a significant difference in the rate of treatment with either the tissue plasminogen activator (tPA) or mechanical thrombectomy during the Peak-COVID period. Interestingly, relative treatment rates increased during the 2020 Post-COVID period to 11.4% (P=0.01). Conclusions. The overall ischemic stroke volume decreased during the pandemic, and patients had a tendency to present later, beyond eligible treatment windows. However, rates of treatment, patient demographics, and stroke outcomes did not significantly change when compared to the prior year.http://dx.doi.org/10.1155/2021/8653396 |
| spellingShingle | Timothy G. White Gabriela Martinez Jason Wang Michele Gribko Artem Boltyenkov Rohan Arora Jeffrey M. Katz Henry H. Woo Pina C. Sanelli Impact of the COVID-19 Pandemic on Acute Ischemic Stroke Presentation, Treatment, and Outcomes Stroke Research and Treatment |
| title | Impact of the COVID-19 Pandemic on Acute Ischemic Stroke Presentation, Treatment, and Outcomes |
| title_full | Impact of the COVID-19 Pandemic on Acute Ischemic Stroke Presentation, Treatment, and Outcomes |
| title_fullStr | Impact of the COVID-19 Pandemic on Acute Ischemic Stroke Presentation, Treatment, and Outcomes |
| title_full_unstemmed | Impact of the COVID-19 Pandemic on Acute Ischemic Stroke Presentation, Treatment, and Outcomes |
| title_short | Impact of the COVID-19 Pandemic on Acute Ischemic Stroke Presentation, Treatment, and Outcomes |
| title_sort | impact of the covid 19 pandemic on acute ischemic stroke presentation treatment and outcomes |
| url | http://dx.doi.org/10.1155/2021/8653396 |
| work_keys_str_mv | AT timothygwhite impactofthecovid19pandemiconacuteischemicstrokepresentationtreatmentandoutcomes AT gabrielamartinez impactofthecovid19pandemiconacuteischemicstrokepresentationtreatmentandoutcomes AT jasonwang impactofthecovid19pandemiconacuteischemicstrokepresentationtreatmentandoutcomes AT michelegribko impactofthecovid19pandemiconacuteischemicstrokepresentationtreatmentandoutcomes AT artemboltyenkov impactofthecovid19pandemiconacuteischemicstrokepresentationtreatmentandoutcomes AT rohanarora impactofthecovid19pandemiconacuteischemicstrokepresentationtreatmentandoutcomes AT jeffreymkatz impactofthecovid19pandemiconacuteischemicstrokepresentationtreatmentandoutcomes AT henryhwoo impactofthecovid19pandemiconacuteischemicstrokepresentationtreatmentandoutcomes AT pinacsanelli impactofthecovid19pandemiconacuteischemicstrokepresentationtreatmentandoutcomes |