TY - JOUR
T1 - Impact of the lockdown on acute stroke treatments during the first surge of the COVID-19 outbreak in the Netherlands
AU - Benali, Faysal
AU - Stolze, Lotte J
AU - Rozeman, Anouk D
AU - Dinkelaar, Wouter
AU - Coutinho, Jonathan M
AU - Emmer, Bart J
AU - Gons, Rob A R
AU - Yo, Lonneke F S
AU - van Tuijl, Julia H
AU - Boukrab, Issam
AU - van Dam-Nolen, Dianne H K
AU - van den Wijngaard, Ido R
AU - Lycklama À Nijeholt, Geert J
AU - de Laat, Karlijn F
AU - van Dijk, Lukas C
AU - den Hertog, Heleen M
AU - Flach, H Zwenneke
AU - Wermer, Marieke J H
AU - van Walderveen, Marianne A A
AU - Brouwers, Paul J A M
AU - Bulut, Tomas
AU - Vermeer, Sarah E
AU - Bernsen, Marie Louise E
AU - Uyttenboogaart, Maarten
AU - Bokkers, Reinoud P H
AU - Boogaarts, Jeroen D
AU - de Leeuw, Frank-Erik
AU - van der Worp, H Bart
AU - van der Schaaf, Irene C
AU - Schonewille, Wouter J
AU - Vos, Jan A
AU - Remmers, Michel J M
AU - Imani, Farshad
AU - Dippel, Diederik W J
AU - van Zwam, Wim H
AU - Nederkoorn, Paul J
AU - van Oostenbrugge, Robert J
N1 - Funding Information:
Diederik WJ Dippel: Reports funding from the Dutch Heart Foundation, Brain Foundation Netherlands, The Netherlands Organization for Health Research and Development, Health Holland Top Sector Life Sciences & Health, and unrestricted grants from Penumbra Inc., Stryker European Operations BV, Medtronic, Thrombolytic Science, LLC and Cerenovus for research, all paid to institution.
Funding Information:
Frank-Erik de Leeuw: supported by a clinical established investigator grant of the Dutch Heart Foundation (grant 2014 T060), and by a VIDI innovational grant from The Netherlands Organization for Health Research and Development, ZonMw (grant 016126351). Furthermore, he is associate editor of the International Journal of Stroke.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/1/11
Y1 - 2022/1/11
N2 - Introduction: 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. Methods: 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. Results: 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 < 0.001). Furthermore, median NIHSS-scores were higher in COVID-19 - suspected or positive patients (7 to 11, p-value of 0.004), door-to-treatment times did not differ significantly when stratified for COVID-19-status. Conclusions: During the first surge of the COVID-19 pandemic, a decline in acute reperfusion treatments and a delay in DGT was seen, which indicates a target for attention. It also appeared that COVID-19-positive or -suspected patients had more severe neurologic symptoms, whereas their EVT-workflow was not affected.
AB - Introduction: 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. Methods: 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. Results: 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 < 0.001). Furthermore, median NIHSS-scores were higher in COVID-19 - suspected or positive patients (7 to 11, p-value of 0.004), door-to-treatment times did not differ significantly when stratified for COVID-19-status. Conclusions: During the first surge of the COVID-19 pandemic, a decline in acute reperfusion treatments and a delay in DGT was seen, which indicates a target for attention. It also appeared that COVID-19-positive or -suspected patients had more severe neurologic symptoms, whereas their EVT-workflow was not affected.
KW - COVID-19
KW - Communicable Disease Control
KW - Endovascular Procedures
KW - Humans
KW - Netherlands/epidemiology
KW - Pandemics
KW - SARS-CoV-2
KW - Stroke/drug therapy
KW - Thrombectomy
KW - Thrombolytic Therapy
KW - Time-to-Treatment
KW - Treatment Outcome
KW - NIHSS
KW - Acute stroke care
KW - Endovascular thrombectomy
KW - Lockdown
KW - Intravenous thrombolytics
UR - http://www.scopus.com/inward/record.url?scp=85122835637&partnerID=8YFLogxK
U2 - 10.1186/s12883-021-02539-4
DO - 10.1186/s12883-021-02539-4
M3 - Article
C2 - 35016635
SN - 1471-2377
VL - 22
JO - BMC Neurology
JF - BMC Neurology
IS - 1
M1 - 22
ER -