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Observational Study
. 2020 Dec;27(12):2491-2498.
doi: 10.1111/ene.14467. Epub 2020 Sep 4.

Impact of COVID-19 outbreak in reperfusion therapies of acute ischaemic stroke in northwest Spain

H Tejada Meza  1   2   3 , Á Lambea Gil  1   3 , A Sancho Saldaña  1   3 , M Martínez-Zabaleta  4 , E Garmendia Lopetegui  5 , E López-Cancio Martínez  6 , M Castañón Apilánez  6 , M Herrera Isasi  7 , J Marta Enguita  7 , B Gómez-Vicente  8 , J F Arenillas  8   9 , N Arenaza Basterrechea  10 , J J Timiraos Fernández  10 , J Sánchez Herrero  11 , J L Maciñeiras Montero  11 , M Castellanos Rodrigo  12 , D Fernández-Coud  12 , I Casado Menéndez  13 , M T Temprano Fernández  13 , M Freijo  14 , A Luna  14 , E J Palacio Portilla  15 , Y Jiménez López  15 , E Rodríguez-Castro  16 , M Rodríguez-Yáñez  16 , J Tejada García  17 , I Beltrán Rodríguez  7 , F Julián-Villaverde  18 , M P Moreno García  18 , J M Trejo Gabriel-Galán  19 , A Echavarría Iñiguez  19 , C Pérez Lázaro  20 , M P Navarro Pérez  20 , J Marta Moreno  1   3 ; NORDICTUS Investigators
Affiliations
Observational Study

Impact of COVID-19 outbreak in reperfusion therapies of acute ischaemic stroke in northwest Spain

H Tejada Meza et al. Eur J Neurol. 2020 Dec.

Abstract

Background and purpose: Spain has been one of the countries more heavily stricken by SARS-CoV-2, which has had huge implications for stroke care. The aim was to analyse the impact of the COVID-19 epidemic outbreak on reperfusion therapies for acute ischaemic stroke in the northwest of Spain.

Methods: This was a Spanish multicentre retrospective observational study based on data from tertiary hospitals of the NORDICTUS network. All patients receiving reperfusion therapy for ischaemic stroke between 30 December 2019 and 3 May 2020 were recorded, and their baseline, clinical and radiological characteristics, extra- and intra-hospital times of action, Code Stroke activation pathway, COVID-19 status, reperfusion rate, and short-term outcome before and after the setting of the emergency state were analysed.

Results: A total of 796 patients received reperfusion therapies for ischaemic stroke. There was a decrease in the number of patients treated per week (46.5 patients per week vs. 39.0 patients per week, P = 0.043) and a delay in out-of-hospital (95.0 vs. 110.0 min, P = 0.001) and door-to-needle times (51.0 vs. 55.0, P = 0.038). Patients receiving endovascular therapy obtained less successful reperfusion rates (92.9% vs. 86.6%, P = 0.016). COVID-19 patients had more in-hospital mortality.

Conclusion: A decrease in the number of patients benefiting from reperfusion therapies was found, with a delay in out-of-hospital and door-to-needle times and worse reperfusion rates in northwest Spain. COVID-19 patients had more in-hospital mortality.

Keywords: COVID-19; Spain; acute stroke therapy; cerebral infarction; ischaemic stroke; thrombectomy; thrombolysis.

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Conflict of interest statement

JF Arenillas reports having received honoraria as speaker/consultant for the following companies: BI, Pfizer, Daiichi, Bayer, Amgen and Medtronic. E Palacio Portilla reports having received honoraria as speaker/consultant for the following companies: Esteve, Rovi, MSD and AMGEN. The following authors have no conflict of interests: H Tejada Meza, Á Lambea Gil, A Sancho Saldaña, M Martínez‐Zabaleta, E Garmendia Lopetegui, E López‐Cancio Martínez, M Castañón Apilánez, M Herrera Isasi, J Marta Enguita, B Gómez‐Vicente, N Arenaza Basterrechea, JJ Timiraos Fernández, J Sánchez, JL Maciñeiras Montero, M Castellanos‐Rodrigo, D Fernández‐Coud, I Casado Menéndez, MT Temprano Fernández, MM Freijo, A Luna, Y Jiménez López, E Rodríguez Castro, M Rodríguez‐Yáñez, J Tejada García, I Beltrán Rodríguez, F Julián‐Villaverde, MP Moreno García, JM Trejo‐Gabriel‐Galán, A Echavarría Iñiguez, C Pérez Lázaro, MP Navarro, J Marta Moreno.

Figures

Figure 1
Figure 1
NORDICTUS network: number of reperfusion therapies for acute ischaemic stroke and number of COVID‐19 cases in northwest Spain.
See this image and copyright information in PMC

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