1. Clinical profile and outcome of non-COVID strokes during pandemic and the pre pandemic period: COVID-Stroke Study Group (CSSG) India
- Author
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Vivek Nambiar, Sathish Parkipandla, Rajsrinivas Parthasarathy, Praveen Panicker, S Kumaravelu, Rajeshwar Sahonta, Rohit Bhatia, Kamal Kajal, Girish Baburao Kulkarni, Vijaya Pamidimukkala, Manshi Kashyap, Githin Benoy George, A V R Taallapalli, Dheeraj Khurana, Ajay Garg, P N Sylaja, Thomas Iype, Rakesh Singh, Hiral Halani, Ayush Agarwal, Ashish Duggal, Nirendra Rai, Sritheja Reddy, Salil Gupta, Vipul Gupta, Roopa Rajan, Shailesh Gaikwad, Anu Gupta, Sapna Erat Sreedharan, P M Yogeesh, Snigdha Komakula, Leve Joseph, Vivek Lal, Arvind Sharma, M V Padma Srivastava, Prashant Dixit, Ashish Datt Upadhyay, Mamta Singh, Pranjal Gupta, Debashish Chowdhury, Sucharita Ray, Jayanta Roy, Vibhor Pardasani, Mamta Parmar, Vamsi Chalasani, Deepti Vibha, Suman Kushwaha, Krishna Sreela, Rajshekar Reddy, Harsh Oza, Biswamohan Misra, Chirag Kamal Ahuja, Sudheer Pachipala, A.K. Pandit, Jeyaraj D Pandian, Srinivasareddy Sanivarapu, Srijithesh P. Rajendran, Manish Salunkhe, Venugopalan Y Vishnu, M K Suresh, Vikas Suri, and Dileep Ramachandran
- Subjects
medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,rTPA, Recombinant Tissue Plasminogen Activator ,medicine.medical_treatment ,CVT, Cerebral Venous Thrombosis ,CSSG, COVID-19 Stroke Study Group ,India ,Stroke care ,Article ,Time-to-Treatment ,TNK, Tenecteplase ,Pandemic ,medicine ,Humans ,Endovascular treatment ,Stroke ,Pandemics ,Retrospective Studies ,COVID-19, Coronavirus disease 2019 ,Ischemic stroke ,RTPCR, Real Time Polymerase Chain Reaction ,business.industry ,SARS-CoV-2 ,NIHSS, National Institutes of Health Stroke Scale ,COVID-19 ,mRS, modified Rankin score ,Retrospective cohort study ,Thrombolysis ,CT, Computed Tomography ,SD, Standard Deviation ,ICH, Intracerebral Hemorrhage ,medicine.disease ,Door to needle time ,Neurology ,Emergency medicine ,Communicable Disease Control ,EVT, Endovascular Therapy ,IQR, Inter-quartile range ,LVO, Large Vessel Occlusion ,Neurology (clinical) ,ASPECTS, Alberta stroke program early CT score ,business - Abstract
Background As the health systems around the world struggled to meet the challenges of COVID-19 pandemic, care of many non-COVID emergencies was affected. Aims The present study examined differences in the diagnosis, evaluation and management of stroke patients during a defined period in the ongoing pandemic in 2020 when compared to a similar epoch in year 2019. Methods The COVID stroke study group (CSSG) India, included 18 stroke centres spread across the country. Data was collected prospectively between February and July 2020 and retrospectively for the same period in 2019. Details of demographics, stroke evaluation, treatment, in-hospital and three months outcomes were collected and compared between these two time points. Results A total of 2549 patients were seen in both study periods; 1237 patients (48.53%) in 2019 and 1312 (51.47%) in 2020. Although the overall number of stroke patients and rates of thrombolysis were comparable, a significant decline was observed in the month of April 2020, during the initial period of the pandemic and lockdown. Endovascular treatment reduced significantly and longer door to needle and CT to needle times were observed in 2020. Although mortality was higher in 2020, proportion of patients with good outcome were similar in both the study periods. Conclusions Although stroke admissions and rates of thrombolysis were comparable, some work flow metrics were delayed, endovascular stroke treatment rates declined and mortality was higher during the pandemic study period. Reorganization of stroke treatment pathways during the pandemic has likely improved the stroke care delivery across the globe.
- Published
- 2021