Mechanical Thrombectomy for Acute Ischemic Stroke Amid the COVID-19 Outbreak: Decreased Activity, and Increased Care Delays

• Published in: Stroke (1970) 2020-07, Vol.51 (7), p.2012-2017
• Main Authors: Kerleroux, Basile, Fabacher, Thibaut, Bricout, Nicolas, Moïse, Martin, Testud, Benoit, Vingadassalom, Sivadji, Ifergan, Héloïse, Janot, Kévin, Consoli, Arturo, Ben Hassen, Wagih, Shotar, Eimad, Ognard, Julien, Charbonnier, Guillaume, L’Allinec, Vincent, Guédon, Alexis, Bolognini, Federico, Marnat, Gaultier, Forestier, Géraud, Rouchaud, Aymeric, Pop, Raoul, Raynaud, Nicolas, Zhu, François, Cortese, Jonathan, Chalumeau, Vanessa, Berge, Jérome, Escalard, Simon, Boulouis, Grégoire
• Format: Article
• Language: English
• Subjects: Advanced and Specialized Nursing; Aged; Aged, 80 and over; Betacoronavirus; Brain Ischemia; Brain Ischemia - epidemiology; Brain Ischemia - surgery; Cardiology and Cardiovascular Medicine; coronavirus; Coronavirus Infections; COVID-19; Delivery of Health Care; Female; France; France - epidemiology; groin; hospitalization; Hospitalization - statistics & numerical data; Human health sciences; Humans; Male; Mechanical Thrombolysis; Mechanical Thrombolysis - methods; Mechanical Thrombolysis - statistics & numerical data; Middle Aged; Neurologie; Neurology; Neurology (clinical); Pandemics; Patient Admission; Patient Admission - statistics & numerical data; Pneumonia, Viral; Procedures and Techniques Utilization; Prospective Studies; SARS-CoV-2; Sciences de la santé humaine; Stroke; Stroke - epidemiology; Stroke - surgery; thrombectomy; Time-to-Treatment; Time-to-Treatment - statistics & numerical data
• ISSN: 0039-2499; 1524-4628; 1524-4628
• DOI: 10.1161/STROKEAHA.120.030373

BACKGROUND AND PURPOSE:The efficiency of prehospital care chain response and the adequacy of hospital resources are challenged amid the coronavirus disease 2019 (COVID-19) outbreak, with suspected consequences for patients with ischemic stroke eligible for mechanical thrombectomy (MT). METHODS:We conducted a prospective national-level data collection of patients treated with MT, ranging 45 days across epidemic containment measures instatement, and of patients treated during the same calendar period in 2019. The primary end point was the variation of patients receiving MT during the epidemic period. Secondary end points included care delays between onset, imaging, and groin puncture. To analyze the primary end point, we used a Poisson regression model. We then analyzed the correlation between the number of MTs and the number of COVID-19 cases hospitalizations, using the Pearson correlation coefficient (compared with the null value). RESULTS:A total of 1513 patients were included at 32 centers, in all French administrative regions. There was a 21% significant decrease (0.79; [95%CI, 0.76–0.82]; P