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Stroke management during the coronavirus disease 2019 (COVID-19) pandemic: experience from three regions of the north east of Italy (Veneto, Friuli-Venezia-Giulia, Trentino-Alto-Adige)

Authors
  • Manganotti, Paolo1
  • Naccarato, Marcello1
  • Scali, Ilario1
  • Cappellari, Manuel2
  • Bonetti, Bruno2
  • Burlina, Alessandro3
  • Turinese, Emanuele3
  • Bogo, Sabrina4
  • Teatini, Francesco5
  • Franchini, Enrica5
  • Caneve, Giorgio6
  • Ruzza, Giampietro6
  • Gaudenzi, Anna7
  • Bombardi, Roberto7
  • Bozzato, Giulio8
  • Padoan, Roberta8
  • Gentile, Carolina9
  • Rana, Michele9
  • Turazzini, Michelangelo10
  • Alessandra, Danese10
  • And 26 more
  • 1 Cattinara University Hospital ASUGI, University of Trieste,
  • 2 Azienda Ospedaliera Universitaria Integrata,
  • 3 Ospedale San Bassiano,
  • 4 Ospedale San Martino,
  • 5 Stroke Unit, Ospedale Centrale, Bolzano, Italy
  • 6 Stroke Unit, Ospedale di Cittadella, Cittadella, Italy
  • 7 Ospedale Santa Maria dei Battuti,
  • 8 Stroke Unit, Ospedale Santa Maria del Prato, Feltre, Italy
  • 9 Stroke Unit, Ospedale di Gorizia, Gorizia, Italy
  • 10 Stroke Unit, Ospedale Mater Salutis, Legnago, Italy
  • 11 Stroke Unit, Ospedale “Franz Tappeiner”, Merano, Italy
  • 12 Ospedale dell’Angelo,
  • 13 Ospedale di Mirano,
  • 14 Stroke Unit, Ospedale Santa Maria degli Angeli, Pordenone, Italy
  • 15 Stroke Unit, Ospedale Di Portogruaro, Portogruaro, Italy
  • 16 Azienda Ospedaliera Università di Padova,
  • 17 Ospedale Sant’Antonio,
  • 18 Ospedale Santa Chiara,
  • 19 Ospedale Ca’ Foncello,
  • 20 Azienda Sanitaria Universitaria Integrata,
  • 21 Stroke Unit, Ospedale Santi Giovanni e Paolo, Venezia, Italy
  • 22 Ospedale San Bortolo,
  • 23 Struttura Complessa Ricerca, innovazione clinico-assistenziale, qualità, accreditamento e rischio clinico, ASUGI, Trieste, Italy
Type
Published Article
Journal
Neurological Sciences
Publisher
Springer-Verlag
Publication Date
Mar 04, 2021
Pages
1–8
Identifiers
DOI: 10.1007/s10072-021-05066-9
PMID: 33661482
PMCID: PMC7930104
Source
PubMed Central
Keywords
Disciplines
  • Original Article
License
Unknown

Abstract

Background Efficiency of care chain response and hospital reactivity were and are challenged for stroke acute care management during the pandemic period of coronavirus disease 2019 (COVID-19) in North-Eastern Italy (Veneto, Friuli-Venezia-Giulia, Trentino-Alto-Adige), counting 7,193,880 inhabitants (ISTAT), with consequences in acute treatment for patients with ischemic stroke. Methods We conducted a retrospective data collection of patients admitted to stroke units eventually treated with thrombolysis and thrombectomy, ranging from January to May 2020 from the beginning to the end of the main first pandemic period of COVID-19 in Italy. The primary endpoint was the number of patients arriving to these stroke units, and secondary endpoints were the number of thrombolysis and/or thrombectomy. Chi-square analysis was used on all patients; furthermore, patients were divided into two cohorts (pre-lockdown and lockdown periods) and the Kruskal-Wallis test was used to test differences on admission and reperfusive therapies. Results In total, 2536 patients were included in 22 centers. There was a significant decrease of admissions in April compared to January. Furthermore, we observed a significant decrease of thrombectomy during the lockdown period, while thrombolysis rate was unaffected in the same interval across all centers. Conclusions Our study confirmed a decrease in admission rate of stroke patients in a large area of northern Italy during the lockdown period, especially during the first dramatic phase. Overall, there was no decrease in thrombolysis rate, confirming an effect of emergency care system for stroke patients. Instead, the significant decrease in thrombectomy rate during lockdown addresses some considerations of local and regional stroke networks during COVID-19 pandemic evolution.

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