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Abstract P99: impact of the Covid-19 pandemic on stroke thrombolysis rate and delay to thrombolysis treatment in a regional stroke centre in London, UK

Title: Abstract P99: impact of the Covid-19 pandemic on stroke thrombolysis rate and delay to thrombolysis treatment in a regional stroke centre in London, UK
Authors: Drumm, B
Bentley, P
Brown, Z
D’Anna, L
Dolkar, T
Halse, O
Jamil, SA
Jenkins, H
Kalladka, D
Venter, M
Banerjee, S
Kwan, J
Item Type: Conference Paper
Abstract: Introduction: There are reports of changes in the numbers of stroke admissions and time intervals to receiving emergency treatments during the COVID-19 pandemic. We examined the impact of the COVID-19 pandemic on the stroke thrombolysis rate and delay to thrombolysis treatment in a regional stroke centre in London, UK. Methods: COVID-19 testing began at our hospital on 3 March 2020. Clinical data for all acute stroke admissions were routinely collected as part of a national Sentinel Stroke National Audit Programme (SSNAP) and all thrombolysis data were entered into our local thrombolysis database. We retrospectively extracted the relevant patient data for the period of March to May 2020 (COVID group) and compared to the same period in 2019 (pre-COVID group). Results: Compared with pre-COVID, there was a 17.5% fall in total stroke admissions (from 315 to 260) during COVID; but there were no significant differences in the demographics, stroke severity, proportions with known time of onset, or median onset-to-arrival time. The thrombolysis rates amongst ischemic strokes were not significantly different between the two groups (59/260=23% pre-COVID vs. 41/228=18% COVID, p=.19). For thrombolysis patients, their stroke severity and demographics were similar between the two both groups. Median onset-to-needle time was significantly longer by 22 minutes during COVID [127 (IQR 94-160) vs. 149 (IQR 110-124) minutes, p=.045]; this delay to treatment was almost entirely due to a longer median onset-to-arrival time by 16 minutes during COVID (p=.029). Favorable early neurological outcomes post-thrombolysis (defined as an improvement in NIHSS by ≥4 points at 24 hours) were similar (45% vs. 46%, p=.86). Conclusion: COVID-19 pandemic had a negative impact on prehospital delays which in turn significantly increased onset-to-needle time, but without affecting the chance of a favorable early neurological outcome. Our data highlight the need to maintain public awareness of taking immediate action when stroke symptoms occur during the COVID-19 pandemic.
Issue Date: 11-Mar-2021
Date of Acceptance: 1-Mar-2021
URI: http://hdl.handle.net/10044/1/90264
DOI: 10.1161/str.52.suppl_1.p99
ISSN: 0039-2499
Publisher: Ovid Technologies (Wolters Kluwer Health)
Start Page: 1
End Page: 1
Journal / Book Title: Stroke
Volume: 52
Issue: Suppl_1
Copyright Statement: © 2021 by American Heart Association, Inc.
Conference Name: International Stroke Conference 2021
Keywords: 1102 Cardiorespiratory Medicine and Haematology
1103 Clinical Sciences
1109 Neurosciences
Neurology & Neurosurgery
Publication Status: Published
Start Date: 2021-03-17
Finish Date: 2021-03-19
Open Access location: https://www.ahajournals.org/doi/10.1161/str.52.suppl_1.P99
Online Publication Date: 2021-03-11
Appears in Collections:Imperial College London COVID-19
Department of Brain Sciences