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

• Published in: BMC neurology 2022-01, Vol.22 (1), p.22-22, Article 22
• Main Authors: Benali, Faysal, Stolze, Lotte J, Rozeman, Anouk D, Dinkelaar, Wouter, Coutinho, Jonathan M, Emmer, Bart J, Gons, Rob A R, Yo, Lonneke F S, van Tuijl, Julia H, Boukrab, Issam, van Dam-Nolen, Dianne H K, van den Wijngaard, Ido R, Lycklama À Nijeholt, Geert J, de Laat, Karlijn F, van Dijk, Lukas C, den Hertog, Heleen M, Flach, H Zwenneke, Wermer, Marieke J H, van Walderveen, Marianne A A, Brouwers, Paul J A M, Bulut, Tomas, Vermeer, Sarah E, Bernsen, Marie Louise E, Uyttenboogaart, Maarten, Bokkers, Reinoud P H, Boogaarts, Jeroen D, de Leeuw, Frank-Erik, van der Worp, H Bart, van der Schaaf, Irene C, Schonewille, Wouter J, Vos, Jan A, Remmers, Michel J M, Imani, Farshad, Dippel, Diederik W J, van Zwam, Wim H, Nederkoorn, Paul J, van Oostenbrugge, Robert J
• Format: Article
• Language: English
• Subjects: Acute stroke care; Ambulatory medical care; Care and treatment; Communicable Disease Control; Control; Coronaviruses; COVID-19; Endovascular Procedures; Endovascular thrombectomy; Epidemics; Humans; Influence; Intravenous thrombolytics; Lockdown; Netherlands; Netherlands - epidemiology; NIHSS; Pandemics; Patient admissions; Patients; Reperfusion; SARS-CoV-2; Statistical analysis; Statistics; Stroke; Stroke (Disease); Stroke - drug therapy; Stroke - therapy; Thrombectomy; Thrombolytic Therapy; Time-to-Treatment; Treatment Outcome; Utilization
• ISSN: 1471-2377; 1471-2377
• DOI: 10.1186/s12883-021-02539-4

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. 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. 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