Impact of COVID-19 on Acute Stroke Presentation at a Comprehensive Stroke Center
Background: COVID-19 has impacted healthcare in many ways, including presentation of acute stroke. Since time-sensitive thrombolysis is essential for reducing morbidity and mortality in acute stroke, any delays due to the pandemic can have serious consequences.Methods: We retrospectively reviewed th...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-08-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2020.00850/full |
| _version_ | 1818037389282508800 |
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| author | Masaki Nagamine Daniel S. Chow Daniel S. Chow Peter D. Chang Peter D. Chang Bernadette Boden-Albala Wengui Yu Jennifer E. Soun |
| author_facet | Masaki Nagamine Daniel S. Chow Daniel S. Chow Peter D. Chang Peter D. Chang Bernadette Boden-Albala Wengui Yu Jennifer E. Soun |
| author_sort | Masaki Nagamine |
| collection | DOAJ |
| description | Background: COVID-19 has impacted healthcare in many ways, including presentation of acute stroke. Since time-sensitive thrombolysis is essential for reducing morbidity and mortality in acute stroke, any delays due to the pandemic can have serious consequences.Methods: We retrospectively reviewed the electronic medical records for patients presenting with acute ischemic stroke at a comprehensive stroke center in March–April 2020 (the early months of COVID-19) and compared to the same time period in 2019. Stroke metrics such as incidence, time to arrival, and immediate outcomes were assessed.Results: There were 48 acute ischemic strokes (of which 7 were transfers) in March–April 2020 compared to 64 (of which 12 were transfers) in 2019. The average last known well to arrival time (±SD) for stroke codes was 1,041 (±1682.1) min in 2020 and 554 (±604.9) min in 2019. Of the patients presenting directly to the ED with a known last known well time, 27.8% (10/36) presented in the first 4.5 h in 2020, in contrast to 40.5% (15/37) in 2019. Patients who died comprised 10.4% of the stroke cohort in 2020 (5/48) compared to 6.3% in 2019 (4/64).Conclusions: During the first 2 months of COVID-19, there were fewer overall stroke cases who presented to our hospital, and of these cases, there was delayed presentation in comparison to the same time period in 2019. Recognizing how stroke presentation may be affected by COVID-19 would allow for optimization of established stroke triage algorithms in order to ensure safe and timely delivery of stroke care during a pandemic. |
| first_indexed | 2024-12-10T07:26:04Z |
| format | Article |
| id | doaj.art-39a2073616c14a5b8a7358711364f872 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-10T07:26:04Z |
| publishDate | 2020-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-39a2073616c14a5b8a7358711364f8722022-12-22T01:57:41ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-08-011110.3389/fneur.2020.00850566905Impact of COVID-19 on Acute Stroke Presentation at a Comprehensive Stroke CenterMasaki Nagamine0Daniel S. Chow1Daniel S. Chow2Peter D. Chang3Peter D. Chang4Bernadette Boden-Albala5Wengui Yu6Jennifer E. Soun7Department of Neurology, University of California, Irvine Medical Center, Orange, CA, United StatesDepartment of Radiological Sciences, University of California, Irvine Medical Center, Orange, CA, United StatesCenter for Artificial Intelligence in Diagnostic Medicine, University of California, Irvine, Irvine, CA, United StatesDepartment of Radiological Sciences, University of California, Irvine Medical Center, Orange, CA, United StatesCenter for Artificial Intelligence in Diagnostic Medicine, University of California, Irvine, Irvine, CA, United StatesDepartment of Population Health and Disease Prevention, Department of Epidemiology, University of California, Irvine, Irvine, CA, United StatesDepartment of Neurology, University of California, Irvine Medical Center, Orange, CA, United StatesDepartment of Radiological Sciences, University of California, Irvine Medical Center, Orange, CA, United StatesBackground: COVID-19 has impacted healthcare in many ways, including presentation of acute stroke. Since time-sensitive thrombolysis is essential for reducing morbidity and mortality in acute stroke, any delays due to the pandemic can have serious consequences.Methods: We retrospectively reviewed the electronic medical records for patients presenting with acute ischemic stroke at a comprehensive stroke center in March–April 2020 (the early months of COVID-19) and compared to the same time period in 2019. Stroke metrics such as incidence, time to arrival, and immediate outcomes were assessed.Results: There were 48 acute ischemic strokes (of which 7 were transfers) in March–April 2020 compared to 64 (of which 12 were transfers) in 2019. The average last known well to arrival time (±SD) for stroke codes was 1,041 (±1682.1) min in 2020 and 554 (±604.9) min in 2019. Of the patients presenting directly to the ED with a known last known well time, 27.8% (10/36) presented in the first 4.5 h in 2020, in contrast to 40.5% (15/37) in 2019. Patients who died comprised 10.4% of the stroke cohort in 2020 (5/48) compared to 6.3% in 2019 (4/64).Conclusions: During the first 2 months of COVID-19, there were fewer overall stroke cases who presented to our hospital, and of these cases, there was delayed presentation in comparison to the same time period in 2019. Recognizing how stroke presentation may be affected by COVID-19 would allow for optimization of established stroke triage algorithms in order to ensure safe and timely delivery of stroke care during a pandemic.https://www.frontiersin.org/article/10.3389/fneur.2020.00850/fullstrokeCOVID-19public healththrombolyticsstroke triage |
| spellingShingle | Masaki Nagamine Daniel S. Chow Daniel S. Chow Peter D. Chang Peter D. Chang Bernadette Boden-Albala Wengui Yu Jennifer E. Soun Impact of COVID-19 on Acute Stroke Presentation at a Comprehensive Stroke Center Frontiers in Neurology stroke COVID-19 public health thrombolytics stroke triage |
| title | Impact of COVID-19 on Acute Stroke Presentation at a Comprehensive Stroke Center |
| title_full | Impact of COVID-19 on Acute Stroke Presentation at a Comprehensive Stroke Center |
| title_fullStr | Impact of COVID-19 on Acute Stroke Presentation at a Comprehensive Stroke Center |
| title_full_unstemmed | Impact of COVID-19 on Acute Stroke Presentation at a Comprehensive Stroke Center |
| title_short | Impact of COVID-19 on Acute Stroke Presentation at a Comprehensive Stroke Center |
| title_sort | impact of covid 19 on acute stroke presentation at a comprehensive stroke center |
| topic | stroke COVID-19 public health thrombolytics stroke triage |
| url | https://www.frontiersin.org/article/10.3389/fneur.2020.00850/full |
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