Abstract 2: Acute Stroke Care During The Covid-19 Pandemic: The Society Of Vascular And Interventional Neurology Collaboration

• Published in: Stroke (1970) 2021-03, Vol.52 (Suppl_1), p.A2-A2
• Main Authors: Siegler, James E, Zha, Alicia, Czap, Alexandra L, Ortega-Gutierrez, Santiago, Farooqui, Mudassir, Liebeskind, David S, Desai, Shashvat, Hassan, Ameer E, Starosciak, Amy K, Linfante, Italo, Rai, Vivek, Thon, Jesse M, Then, Ryna, Heslin, Mark, Thau, Lauren, Khandelwal, Priyank, Mohammaden, Mahmoud, Haussen, Diogo C, Nogueira, Raul G, Jillella, Dinesh V, Kaliaev, Artem, Nguyen, Thanh, Zaidat, Osama O, Jovin, Tudor G, Jadhav, Ashutosh
• Format: Article
• Language: English
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/str.52.suppl_1.2

BackgroundWe sought to evaluate whether the coronavirus disease 2019 (COVID-19) pandemic may have contributed to delays in acute stroke management at Comprehensive Stroke Centers (CSCs). MethodsPooled clinical data of consecutive adult stroke patients from 12 U.S. CSCs (1/1/2019-5/31/2020) were queried. The rate of thrombolysis for non-transferred patients within the TargetStroke goal of 60min was compared between patients admitted 3/1/2019-5/31/2019 (pre-COVID-19) and 3/1/2020-5/31/2020 (COVID-19). The time from arrival to imaging and treatment with thrombolysis or thrombectomy, as continuous variables, were also assessed. ResultsOf the 7906 patients included, 1319 were admitted pre-COVID-19 and 933 were admitted during COVID-19, 15% of whom underwent intravenous thrombolysis. There was no difference in the rate of thrombolysis within 60min during COVID-19 (OR 0.88, 95%CI 0.42-1.86, p=0.74), despite adjustment for variables associated with earlier treatment (adjusted OR 0.82, 95%CI 0.38-1.76, p=0.61). There was no significant overall delay to thrombolysis during the COVID-19 period vs. pe-COVID-19 (p=0.42), even after multivariable adjustment (p=0.63) or after comparison across months leading to COVID-19 (Figure). The only independent predictor of delayed treatment time between periods was the use of emergency medical services (adjusted β=-6.93, 95%CI -12.83 - -1.04, p=0.03). There was no significant delay from hospital arrival to imaging in all patients, or imaging to skin puncture in patients who underwent thrombectomy. ConclusionsThere was no independent effect of the COVID-19 period on delays in acute care with respect to thrombolysis or thrombectomy in this multicenter observational cohort. Further studies are warranted to externally validate these findings, and determine if site volume or center accreditation may mediate a collateral effect of the pandemic on stroke care paradigms.