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Impact of COVID-19 outbreak in reperfusion therapies of acute ischaemic stroke in northwest Spain.
Eur J Neurol. 2020 Aug 06 [Online ahead of print]EJ

Abstract

BACKGROUND AND PURPOSE

Spain has been one of the countries more heavily stricken by SARS-CoV-2, which has had huge implications for stroke care. The aim was to analyse the impact of the COVID-19 epidemic outbreak on reperfusion therapies for acute ischaemic stroke in the northwest of Spain.

METHODS

This was a Spanish multicentre retrospective observational study based on data from tertiary hospitals of the NORDICTUS network. All patients receiving reperfusion therapy for ischaemic stroke between 30 December 2019 and 3 May 2020 were recorded, and their baseline, clinical and radiological characteristics, extra- and intra-hospital times of action, Code Stroke activation pathway, COVID-19 status, reperfusion rate, and short-term outcome before and after the setting of the emergency state were analysed.

RESULTS

A total of 796 patients received reperfusion therapies for ischaemic stroke. There was a decrease in the number of patients treated per week (46.5 patients per week vs. 39.0 patients per week, P = 0.043) and a delay in out-of-hospital (95.0 vs. 110.0 min, P = 0.001) and door-to-needle times (51.0 vs. 55.0, P = 0.038). Patients receiving endovascular therapy obtained less successful reperfusion rates (92.9% vs. 86.6%, P = 0.016). COVID-19 patients had more in-hospital mortality.

CONCLUSION

A decrease in the number of patients benefiting from reperfusion therapies was found, with a delay in out-of-hospital and door-to-needle times and worse reperfusion rates in northwest Spain. COVID-19 patients had more in-hospital mortality.

Authors+Show Affiliations

Stroke Unit, Department of Neurology, Hospital Universitario Miguel Servet, Zaragoza, Spain. Interventional Neuroradiology Unit, Department of Radiology, Hospital Universitario Miguel Servet, Zaragoza, Spain. Instituto de Investigación Sanitaria de Aragón (IISAragón), Zaragoza, Spain.Stroke Unit, Department of Neurology, Hospital Universitario Miguel Servet, Zaragoza, Spain. Instituto de Investigación Sanitaria de Aragón (IISAragón), Zaragoza, Spain.Stroke Unit, Department of Neurology, Hospital Universitario Miguel Servet, Zaragoza, Spain. Instituto de Investigación Sanitaria de Aragón (IISAragón), Zaragoza, Spain.Department of Neurology, Donostia University Hospital, San Sebastián, Spain.Department of Neuroradiology, Donostia University Hospital, San Sebastián, Spain.Department of Neurology, Hospital Universitario Central de Asturias, Oviedo, Spain.Department of Neurology, Hospital Universitario Central de Asturias, Oviedo, Spain.Department of Neurology, Complejo Hospitalario de Navarra, Pamplona, Spain.Department of Neurology, Complejo Hospitalario de Navarra, Pamplona, Spain.Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain. Neurovascular Research Laboratory, Instituto de Biología y Genética Molecular, Universidad de Valladolid - Consejo Superior de Investigaciones Científicas, Madrid, Spain.Stroke Unit, Department of Neurology, Hospital Universitario de Araba, Vitoria, Spain.Stroke Unit, Department of Neurology, Hospital Universitario de Araba, Vitoria, Spain.Department of Neurology, Complejo Hospitalario Universitario de Vigo, Vigo, Spain.Department of Neurology, Complejo Hospitalario Universitario de Vigo, Vigo, Spain.Department of Neurology, Complexo Hospitalario Universitario A Coruña / A Coruña Biomedical Research Insitute, A Coruña, Spain.Department of Neurology, Complexo Hospitalario Universitario A Coruña / A Coruña Biomedical Research Insitute, A Coruña, Spain.Stroke Unit, Department of Neurology, Hospital Universitario de Cabueñes, Gijón, Spain.Stroke Unit, Department of Neurology, Hospital Universitario de Cabueñes, Gijón, Spain.Neurovascular Department Biocruces Bizkaia Health Research Institute, Osakidetza, Hospital Universitario Cruces, Barakaldo, Spain.Neurovascular Department Biocruces Bizkaia Health Research Institute, Osakidetza, Hospital Universitario Cruces, Barakaldo, Spain.Department of Neurology, Hospital Universitario Marqués de Valdecilla, Santander, Spain.Department of Neurology, Hospital Universitario Marqués de Valdecilla, Santander, Spain.Department of Neurology, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain.Department of Neurology, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain.Department of Neurology, Complejo Asistencial Universitario de León, León, Spain.Department of Neurology, Complejo Hospitalario de Navarra, Pamplona, Spain.Department of Neurology, Hospital San Pedro, Logroño, Spain.Department of Neurology, Hospital San Pedro, Logroño, Spain.Department of Neurology, Complejo Asistencial Universitario de Burgos, Burgos, Spain.Department of Neurology, Complejo Asistencial Universitario de Burgos, Burgos, Spain.Department of Neurology, Hospital Clínico Lozano Blesa, Zaragoza, Spain.Department of Neurology, Hospital Clínico Lozano Blesa, Zaragoza, Spain.Stroke Unit, Department of Neurology, Hospital Universitario Miguel Servet, Zaragoza, Spain. Instituto de Investigación Sanitaria de Aragón (IISAragón), Zaragoza, Spain.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32761981

Citation

Tejada Meza, H, et al. "Impact of COVID-19 Outbreak in Reperfusion Therapies of Acute Ischaemic Stroke in Northwest Spain." European Journal of Neurology, 2020.
Tejada Meza H, Lambea Gil Á, Sancho Saldaña A, et al. Impact of COVID-19 outbreak in reperfusion therapies of acute ischaemic stroke in northwest Spain. Eur J Neurol. 2020.
Tejada Meza, H., Lambea Gil, Á., Sancho Saldaña, A., Martínez-Zabaleta, M., Garmendia Lopetegui, E., López-Cancio Martínez, E., Castañón Apilánez, M., Herrera Isasi, M., Marta Enguita, J., Gómez-Vicente, B., Arenillas, J. F., Arenaza Basterrechea, N., Timiraos Fernández, J. J., Sánchez Herrero, J., Maciñeiras Montero, J. L., Castellanos Rodrigo, M., Fernández-Coud, D., Casado Menéndez, I., Temprano Fernández, M. T., ... Marta Moreno, J. (2020). Impact of COVID-19 outbreak in reperfusion therapies of acute ischaemic stroke in northwest Spain. European Journal of Neurology. https://doi.org/10.1111/ene.14467
Tejada Meza H, et al. Impact of COVID-19 Outbreak in Reperfusion Therapies of Acute Ischaemic Stroke in Northwest Spain. Eur J Neurol. 2020 Aug 6; PubMed PMID: 32761981.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of COVID-19 outbreak in reperfusion therapies of acute ischaemic stroke in northwest Spain. AU - Tejada Meza,H, AU - Lambea Gil,Á, AU - Sancho Saldaña,A, AU - Martínez-Zabaleta,M, AU - Garmendia Lopetegui,E, AU - López-Cancio Martínez,E, AU - Castañón Apilánez,M, AU - Herrera Isasi,M, AU - Marta Enguita,J, AU - Gómez-Vicente,B, AU - Arenillas,J F, AU - Arenaza Basterrechea,N, AU - Timiraos Fernández,J J, AU - Sánchez Herrero,J, AU - Maciñeiras Montero,J L, AU - Castellanos Rodrigo,M, AU - Fernández-Coud,D, AU - Casado Menéndez,I, AU - Temprano Fernández,M T, AU - Freijo,M, AU - Luna,A, AU - Palacio Portilla,E J, AU - Jiménez López,Y, AU - Rodríguez-Castro,E, AU - Rodríguez-Yáñez,M, AU - Tejada García,J, AU - Beltrán Rodríguez,I, AU - Julián-Villaverde,F, AU - Moreno García,M P, AU - Trejo Gabriel-Galán,J M, AU - Echavarría Iñiguez,A, AU - Pérez Lázaro,C, AU - Navarro Pérez,M P, AU - Marta Moreno,J, AU - ,, Y1 - 2020/08/06/ PY - 2020/06/24/received PY - 2020/08/01/accepted PY - 2020/8/8/pubmed PY - 2020/8/8/medline PY - 2020/8/8/entrez KW - COVID-19 KW - Spain KW - acute stroke therapy KW - cerebral infarction KW - ischaemic stroke KW - thrombectomy KW - thrombolysis JF - European journal of neurology JO - Eur. J. Neurol. N2 - BACKGROUND AND PURPOSE: Spain has been one of the countries more heavily stricken by SARS-CoV-2, which has had huge implications for stroke care. The aim was to analyse the impact of the COVID-19 epidemic outbreak on reperfusion therapies for acute ischaemic stroke in the northwest of Spain. METHODS: This was a Spanish multicentre retrospective observational study based on data from tertiary hospitals of the NORDICTUS network. All patients receiving reperfusion therapy for ischaemic stroke between 30 December 2019 and 3 May 2020 were recorded, and their baseline, clinical and radiological characteristics, extra- and intra-hospital times of action, Code Stroke activation pathway, COVID-19 status, reperfusion rate, and short-term outcome before and after the setting of the emergency state were analysed. RESULTS: A total of 796 patients received reperfusion therapies for ischaemic stroke. There was a decrease in the number of patients treated per week (46.5 patients per week vs. 39.0 patients per week, P = 0.043) and a delay in out-of-hospital (95.0 vs. 110.0 min, P = 0.001) and door-to-needle times (51.0 vs. 55.0, P = 0.038). Patients receiving endovascular therapy obtained less successful reperfusion rates (92.9% vs. 86.6%, P = 0.016). COVID-19 patients had more in-hospital mortality. CONCLUSION: A decrease in the number of patients benefiting from reperfusion therapies was found, with a delay in out-of-hospital and door-to-needle times and worse reperfusion rates in northwest Spain. COVID-19 patients had more in-hospital mortality. SN - 1468-1331 UR - https://www.unboundmedicine.com/medline/citation/32761981/Impact_of_COVID-19_outbreak_in_reperfusion_therapies_of_acute_ischemic_stroke_in_North-West_Spain L2 - https://doi.org/10.1111/ene.14467 DB - PRIME DP - Unbound Medicine ER -