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. 2021 Jul;268(7):2314-2319.
doi: 10.1007/s00415-020-10199-6. Epub 2020 Sep 9.

Effect of the COVID-19 pandemic on acute stroke reperfusion therapy: data from the Lyon Stroke Center Network

Cécile Plumereau  1   2 , Tae-Hee Cho  2   3 , Marielle Buisson  4 , Camille Amaz  4 , Matteo Cappucci  5 , Laurent Derex  2   6 , Elodie Ong  2   3 , Julia Fontaine  2 , Lucie Rascle  2 , Roberto Riva  5 , David Schiavo  1 , Axel Benhamed  1 , Marion Douplat  1 , Thomas Bony  1 , Karim Tazarourte  1   6 , Célia Tuttle  5 , Omer Faruk Eker  5 , Yves Berthezène  5   7 , Michel Ovize  3   4 , Norbert Nighoghossian  2   3 , Laura Mechtouff  8   9
Affiliations

Effect of the COVID-19 pandemic on acute stroke reperfusion therapy: data from the Lyon Stroke Center Network

Cécile Plumereau et al. J Neurol. 2021 Jul.

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic would have particularly affected acute stroke care. However, its impact is clearly inherent to the local stroke network conditions. We aimed to assess the impact of COVID-19 pandemic on acute stroke care in the Lyon comprehensive stroke center during this period.

Methods: We conducted a prospective data collection of patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT) during the COVID-19 period (from 29/02/2020 to 10/05/2020) and a control period (from 29/02/2019 to 10/05/2019). The volume of reperfusion therapies and pre and intra-hospital delays were compared during both periods.

Results: A total of 208 patients were included. The volume of IVT significantly decreased during the COVID-period [55 (54.5%) vs 74 (69.2%); p = 0.03]. The volume of MT remains stable over the two periods [72 (71.3%) vs 65 (60.8%); p = 0.14], but the door-to-groin puncture time increased in patients transferred for MT (237 [187-339] vs 210 [163-260]; p < 0.01). The daily number of Emergency Medical Dispatch calls considerably increased (1502 [1133-2238] vs 1023 [960-1410]; p < 0.01).

Conclusions: Our study showed a decrease in the volume of IVT, whereas the volume of MT remained stable although intra-hospital delays increased for transferred patients during the COVID-19 pandemic. These results contrast in part with the national surveys and suggest that the impact of the pandemic may depend on local stroke care networks.

Keywords: COVID-19; Stroke; Thrombectomy; Thrombolysis.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Stroke care network in the northern Rhône valley [inset, location within France; CSC Comprehensive Stroke Center, PSC Primary Stroke Center. Sourvdfce: Institut national de l’information géographique et forestière (IGN)]
Fig. 2
Fig. 2
Patient pathways and procedures during the control and the COVID-19 periods (CSC comprehensive stroke center, PCS primary stroke center, ED emergency department, IVT intravenous thrombolysis, MT mechanical thrombectomy)
Fig. 3
Fig. 3
Cumulative number of reperfusion procedures (intravenous thrombolysis and thrombectomy) from January 1st to May 10th from 2015 to 2020 (the dashed line shows the slope of case numbers in 2020 before the COVID-19 period)
See this image and copyright information in PMC

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