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Universal laboratory testing for SARS-CoV-2 in hyperacute stroke during the COVID-19 pandemic.
J Stroke Cerebrovasc Dis. 2020 Sep; 29(9):105061.JS

Abstract

OBJECTIVE

Stroke patients are thought to be at increased risk of Coronavirus Disease 2019 (COVID-19). To evaluate yield of universal laboratory testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in acute stroke patients and its impact on hyperacute stroke care.

METHODS

Between weeks 14 and 18 in 2020, a protected code stroke protocol including infection control screening and laboratory testing for SARS-CoV-2 was prospectively implemented for all code stroke patients upon arrival to the emergency department. If infection control screen was positive, patients received protective hygienic measures and laboratory test results were available within four hours from testing. In patients with negative screen, laboratory results were available no later than the next working day. Door-to-imaging times of patients treated with thrombolysis or thrombectomy were compared with those of patients treated during the preceding weeks 1 to 13 in 2020.

RESULTS

During the 4-weeks study period, 116 consecutive code stroke patients underwent infection control screen and laboratory testing for SARS-CoV-2. Among 5 (4.3%) patients whose infection control screen was positive, no patient was tested positive for SARS-CoV-2. All patients with negative infection control screens had negative test results. Door-to-imaging times of patients treated with thrombolysis and/or thrombectomy were not different to those treated during the preceding weeks (12 [9-15] min versus 13 [11-17] min, p = 0.24).

CONCLUSIONS

Universal laboratory testing for SARS-CoV-2 provided useful information on patients' infection status and its implementation into a protected code stroke protocol did not adversely affect hyperacute stroke care.

Authors+Show Affiliations

Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraβe 74, Dresden 01307, Germany. Electronic address: kristian.barlinn@ukdd.de.Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraβe 74, Dresden 01307, Germany. Electronic address: timo.siepmann@ukdd.de.Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraβe 74, Dresden 01307, Germany. Electronic address: lars.peder-pallesen@ukdd.de.Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraβe 74, Dresden 01307, Germany. Electronic address: simon.winzer@ukdd.de.Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraβe 74, Dresden 01307, Germany. Electronic address: annahita.sedghi@ukdd.de.Department of Virology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany. Electronic address: percy.schroettner@tu-dresden.de.Department of Virology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany. Electronic address: Kristina.Hochauf-Stange@uniklinikum-dresden.de.Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraβe 74, Dresden 01307, Germany. Electronic address: alexandra.prakapenia@ukdd.de.Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraβe 74, Dresden 01307, Germany. Electronic address: haidar.moustafa@ukdd.de.Division of Infectious Diseases, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany. Electronic address: katja.dewith@ukdd.de.Institute of Diagnostic and Interventional Neuroradiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany. Electronic address: jennifer.linn@ukdd.de.Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraβe 74, Dresden 01307, Germany. Electronic address: heinz.reichmann@ukdd.de.Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraβe 74, Dresden 01307, Germany. Electronic address: jessica.barlinn@ukdd.de.Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraβe 74, Dresden 01307, Germany. Electronic address: volker.puetz@ukdd.de.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

32807466

Citation

Barlinn, Kristian, et al. "Universal Laboratory Testing for SARS-CoV-2 in Hyperacute Stroke During the COVID-19 Pandemic." Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association, vol. 29, no. 9, 2020, p. 105061.
Barlinn K, Siepmann T, Pallesen LP, et al. Universal laboratory testing for SARS-CoV-2 in hyperacute stroke during the COVID-19 pandemic. J Stroke Cerebrovasc Dis. 2020;29(9):105061.
Barlinn, K., Siepmann, T., Pallesen, L. P., Winzer, S., Sedghi, A., Schroettner, P., Hochauf-Stange, K., Prakapenia, A., Moustafa, H., de With, K., Linn, J., Reichmann, H., Barlinn, J., & Puetz, V. (2020). Universal laboratory testing for SARS-CoV-2 in hyperacute stroke during the COVID-19 pandemic. Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association, 29(9), 105061. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105061
Barlinn K, et al. Universal Laboratory Testing for SARS-CoV-2 in Hyperacute Stroke During the COVID-19 Pandemic. J Stroke Cerebrovasc Dis. 2020;29(9):105061. PubMed PMID: 32807466.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Universal laboratory testing for SARS-CoV-2 in hyperacute stroke during the COVID-19 pandemic. AU - Barlinn,Kristian, AU - Siepmann,Timo, AU - Pallesen,Lars-Peder, AU - Winzer,Simon, AU - Sedghi,Annahita, AU - Schroettner,Percy, AU - Hochauf-Stange,Kristina, AU - Prakapenia,Alexandra, AU - Moustafa,Haidar, AU - de With,Katja, AU - Linn,Jennifer, AU - Reichmann,Heinz, AU - Barlinn,Jessica, AU - Puetz,Volker, Y1 - 2020/06/20/ PY - 2020/05/26/received PY - 2020/06/07/revised PY - 2020/06/12/accepted PY - 2020/8/19/entrez PY - 2020/8/19/pubmed PY - 2020/8/25/medline KW - Acute Stroke KW - COVID-19 KW - Patient safety KW - SARS-CoV-2 KW - Stroke protocol SP - 105061 EP - 105061 JF - Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association JO - J Stroke Cerebrovasc Dis VL - 29 IS - 9 N2 - OBJECTIVE: Stroke patients are thought to be at increased risk of Coronavirus Disease 2019 (COVID-19). To evaluate yield of universal laboratory testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in acute stroke patients and its impact on hyperacute stroke care. METHODS: Between weeks 14 and 18 in 2020, a protected code stroke protocol including infection control screening and laboratory testing for SARS-CoV-2 was prospectively implemented for all code stroke patients upon arrival to the emergency department. If infection control screen was positive, patients received protective hygienic measures and laboratory test results were available within four hours from testing. In patients with negative screen, laboratory results were available no later than the next working day. Door-to-imaging times of patients treated with thrombolysis or thrombectomy were compared with those of patients treated during the preceding weeks 1 to 13 in 2020. RESULTS: During the 4-weeks study period, 116 consecutive code stroke patients underwent infection control screen and laboratory testing for SARS-CoV-2. Among 5 (4.3%) patients whose infection control screen was positive, no patient was tested positive for SARS-CoV-2. All patients with negative infection control screens had negative test results. Door-to-imaging times of patients treated with thrombolysis and/or thrombectomy were not different to those treated during the preceding weeks (12 [9-15] min versus 13 [11-17] min, p = 0.24). CONCLUSIONS: Universal laboratory testing for SARS-CoV-2 provided useful information on patients' infection status and its implementation into a protected code stroke protocol did not adversely affect hyperacute stroke care. SN - 1532-8511 UR - https://www.unboundmedicine.com/medline/citation/32807466/Universal_laboratory_testing_for_SARS_CoV_2_in_hyperacute_stroke_during_the_COVID_19_pandemic_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1052-3057(20)30479-1 DB - PRIME DP - Unbound Medicine ER -