Impact of the lockdown on acute stroke treatments during the first surge of the COVID-19 outbreak in the Netherlands

BMC Neurology

H. Bart van der Worp¹  Irene C. van der Schaaf¹  Robert J. van Oostenbrugge²  Wim H. van Zwam²  Faysal Benali²  Wouter Dinkelaar³  Anouk D. Rozeman³  Farshad Imani⁴  Michel J. M. Remmers⁴  Bart J. Emmer⁵  Paul J. Nederkoorn⁵  Jonathan M. Coutinho⁵  Lotte J. Stolze⁵  Rob A. R. Gons⁶  Lonneke F. S. Yo⁶  Julia H. van Tuijl⁷  Issam Boukrab⁷  Diederik W. J. Dippel⁸  Dianne H. K. van Dam-Nolen⁸  Geert J. Lycklama à Nijeholt⁹  Ido R. van den Wijngaard⁹  Karlijn F. de Laat^1,10  Lukas C. van Dijk^1,10  Heleen M. den Hertog^1,11  H. Zwenneke Flach^1,11  Marieke J. H. Wermer^1,12  Marianne A. A. van Walderveen^1,12  Tomas Bulut^1,13  Paul J. A. M. Brouwers^1,13  Sarah E. Vermeer^1,14  Marie Louise E. Bernsen^1,14  Wouter J. Schonewille^1,15  Jan A. Vos^1,15  Reinoud P. H. Bokkers^1,16  Maarten Uyttenboogaart^1,16  Frank-Erik de Leeuw^1,17  Jeroen D. Boogaarts^1,17 

[1] Department of Neurology and Neurosurgery and Radiology, University Medical Center Utrecht;Department of Neurology and Radiology & Nuclear Medicine, Maastricht University Medical Center;Department of Neurology and Radiology, Albert Schweitzer Hospital;Department of Neurology and Radiology, Amphia Hospital;Department of Neurology and Radiology, Amsterdam UMC;Department of Neurology and Radiology, Catharina Hospital;Department of Neurology and Radiology, Elisabeth TweeSteden Hospital;Department of Neurology and Radiology, Erasmus University Medical Center;Department of Neurology and Radiology, Haaglanden Medical Center;Department of Neurology and Radiology, Haga Hospital;Department of Neurology and Radiology, Isala Hospital;Department of Neurology and Radiology, Leiden University Medical Center;Department of Neurology and Radiology, Medisch Spectrum Twente;Department of Neurology and Radiology, Rijnstate Hospital;Department of Neurology and Radiology, Sint Antonius Hospital;Department of Neurology and Radiology, University Medical Center Groningen;Department of Neurosurgery and Neurology, Radboud University Nijmegen Medical Center;

关键词: COVID-19;    Lockdown;    Acute stroke care;    Intravenous thrombolytics;    Endovascular thrombectomy;    NIHSS;   

DOI  :  10.1186/s12883-021-02539-4

来源: DOAJ

【 摘 要 】

Abstract Introduction We investigated the impact of the Corona Virus Disease 2019 (COVID-19) pandemic and the resulting lockdown on reperfusion treatments and door-to-treatment times during the first surge in Dutch comprehensive stroke centers. Furthermore, we studied the association between COVID-19-status and treatment times. Methods We included all patients receiving reperfusion treatment in 17 Dutch stroke centers from May 11th, 2017, until May 11th, 2020. We collected baseline characteristics, National Institutes of Health Stroke Scale (NIHSS) at admission, onset-to-door time (ODT), door-to-needle time (DNT), door-to-groin time (DGT) and COVID-19-status at admission. Parameters during the lockdown (March 15th, 2020 until May 11th, 2020) were compared with those in the same period in 2019, and between groups stratified by COVID-19-status. We used nationwide data and extrapolated our findings to the increasing trend of EVT numbers since May 2017. Results A decline of 14% was seen in reperfusion treatments during lockdown, with a decline in both IVT and EVT delivery. DGT increased by 12 min (50 to 62 min, p-value of < 0.001). Furthermore, median NIHSS-scores were higher in COVID-19 - suspected or positive patients (7 to 11, p-value of 0.004), door-to-treatment times did not differ significantly when stratified for COVID-19-status. Conclusions During the first surge of the COVID-19 pandemic, a decline in acute reperfusion treatments and a delay in DGT was seen, which indicates a target for attention. It also appeared that COVID-19-positive or -suspected patients had more severe neurologic symptoms, whereas their EVT-workflow was not affected.

【 授权许可】

Unknown