Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep;27(9):1783-1787.
doi: 10.1111/ene.14316. Epub 2020 Jun 3.

Impact of the COVID-19 outbreak on acute stroke pathways - insights from the Alsace region in France

R Pop  1   2 , V Quenardelle  3 , A Hasiu  1 , D Mihoc  1 , F Sellal  4 , M H Dugay  4 , P A Lebedinsky  5 , E Schluck  6 , A LA Porta  6 , S Courtois  6 , R Gheoca  3 , V Wolff  3 , R Beaujeux  1   2
Affiliations

Impact of the COVID-19 outbreak on acute stroke pathways - insights from the Alsace region in France

R Pop et al. Eur J Neurol. 2020 Sep.

Abstract

Background and purpose: To date, no study has attempted to quantify the impact of the COVID-19 outbreak on the incidence and treatment of acute stroke.

Methods: This was a retrospective review of acute stroke pathway parameters in all three stroke units in the Alsace region during the first month of the outbreak (1-31 March 2020), using the similar period from 2019 as a comparator. A secondary detailed analysis of all stroke alerts and stroke unit admissions was performed in the centre with the largest case volume.

Results: Compared to the same period in 2019, in March 2020 there were 39.6% fewer stroke alerts and 33.3% fewer acute revascularization treatments [40.9% less intravenous thrombolysis (IVT) and 27.6% less mechanical thrombectomy (MT)]. No marked variation was observed in the number of stroke unit admissions (-0.6%). The proportion of patients with acute revascularization treatments (IVT or MT) out of the total number of stroke unit admissions was significantly lower in March 2020 (21.3%) compared to 2019 (31.8%), P = 0.034. There were no significant differences in time delays or severity of clinical symptoms for patients treated by IVT or MT, nor in the distribution of final diagnosis amongst stroke alerts and stroke unit admissions.

Conclusion: These results suggest that the overall incidence of stroke remained the same, but fewer patients presented within the therapeutic time window. Increased public awareness and corrective measures are needed to mitigate the deleterious effects of the COVID-19 outbreak on acute stroke care.

Keywords: COVID-19; acute stroke pathway; stroke; thrombectomy; thrombolysis.

PubMed Disclaimer

Conflict of interest statement

None declared.

References

    1. Bernard Stoecklin S, Rolland P, Silue Y, et al. First cases of coronavirus disease 2019 (COVID‐19) in France: surveillance, investigations and control measures, January 2020. Eurosurveillance 2020; 25. - PMC - PubMed
    1. Available from: https://www.gouvernement.fr/info‐coronavirus/carte‐et‐donnees (accessed 20/03/2020).
    1. Oriol R‐L, Belén C‐Á, Soledad O, et al. Impacto de la pandemia de COVID‐19 sobre la actividad asistencial en cardiologia intervencionista en Espana. REC: Interv Cardiol 2020; 2: 82–89.
    1. Tam CF, Cheung KS, Lam S, et al. Impact of coronavirus disease 2019 (COVID‐19) outbreak on ST‐segment‐elevation myocardial infarction care in Hong Kong, China. Circ Cardiovasc Qual Outcomes 2020; 13: 1–4. - PMC - PubMed
    1. Baracchini C, Pieroni A, Viaro F, et al. Acute stroke management pathway during Coronavirus‐19 pandemic. Neurol Sci 2020;41: 1003–1005. - PMC - PubMed