Impact of the COVID-19 pandemic and post-epidemic periods on the process of endovascular treatment for acute anterior circulation ischaemic stroke

Abstract

Background and purpose The purpose of our study was to analyse endovascular treatment (EVT) in patients presenting acute anterior circulation ischemic stroke with large-vessel occlusion (AIS-LVO) during the pandemic and post-epidemic periods. Methods Patients with AIS-LVO of the anterior circulation who underwent EVT were enrolled. According to the times of Wuhan closure and reopening, patients were divided into a pre-pandemic group (from November 8, 2019, to January 22, 2020), pandemic group (from January 23, 2020, to April 8, 2020) and post-epidemic group (from April 9, 2020, to June 24, 2020). The primary endpoints were the time delay among symptom onset to arriving hospital door, to groining puncture and to vascular reperfusion. Secondary endpoints were the functional outcomes evaluated by 90-day modified Rankin scale (mRS) score. Results In total, the times from onset to reperfusion (OTR, median 356 min vs. 310 min, p = 0.041) and onset to door (OTD, median 238 min vs. 167 min, p = 0.017) were prolonged in the pandemic group compared to the pre-pandemic group, and the delay continue in the post-epidemic period. In the subgroup analysis, the time from door to imaging (DTI) was significantly prolonged during the pandemic period. Interestingly, the prolonged DTI was corrected in the directly admitted subgroup during post-epidemic period. In addition, the functional outcomes showed no significant differences across the three periods. Conclusions Total time and prehospital time were prolonged during the pandemic and post-epidemic periods. Urgent public education and improved in-hospital screening processes are necessary to decrease time delays.

Navigating stroke care during the COVID-19 pandemic: A scoping review

“…The included articles were composed of 46 retrospective studies (cohort (n=7); observational (n=11); cross-sectional (n=3); archive (n=1); review (n=1); unspecified (n=23)); 10 prospective studies (cohort (n=2); observational (n=3); cross-sectional (n=3); unspecified (n=2)); 26 observational studies (reports (n=9); cohort (n=7); cross-sectional (n=1); unspecified (n=9)); one matched pairs study; and one survey and one exploratory design. The included articles demonstrated wide geographical spread spanning Bangladesh 29 ; Canada 30–32; Chile 33 ; China 15,34–37,37–44; Egypt 45 ; Finland 46 ; France 47 ; Germany 48–50; India 51 ; Iran 52,53 ; Israel 54–56; Italy 8,57–67; Japan 9,68 ; Lithuania 69 ; Malaysia 70 ; Netherlands 71 ; Norway 72,73 ; Saudi Arabia 74,75 ; Spain 76–79; Switzerland 80 ; Taiwan 81 ; United Kingdom 82–84; and United States of America 7,20,24,39,85–104 . The studies encompassed participants from a wide range of diverse backgrounds, including individuals from various racial and ethnic communities, linguistic minorities, and persons with differing levels of disability.…”

“…Many articles discussed the impact of the COVID-19 pandemic on hospital admissions for stroke patients 9,15,29,36,40,44,45,[47][48][49][50][51][52][53][54]58,60,61,65,66,69,71,72,82,83,86,88,91,103,104 . A few articles mentioned a decrease in the number of stroke admissions during the pandemic 29,39,40,52,53,69,72,76,77,79,83,84,90,97,107 despite reperfusion therapy, thrombolysis and thrombectomy rates remaining unchanged during this period 50,54,63,65,…”

“…There was a reduction in stroke admissions and longer treatment times. Zhang et al [44] Analyze EVT in patients presenting acute anterior circulation AIS-LVO during the pandemic and postepidemic periods.…”

Association of self-leadership and epidemic risk perception on quality of life in post-pandemic mainland of China: a cross-sectional study

“…Since the first case of COVID-19 was reported in Wuhan, China in December 2019 (2), more than 762 million confirmed cases and 6.8 million deaths worldwide have been reported by the World Health Organization (WHO) as of April 8, 2023 (3). China adopted proactive control policies in June 2020 to fight COVID-19 and has entered the post-pandemic era (4,5) with the majority of the population vaccinated (6) and a lower fatality rate than before (7). Studies in various countries (8)(9)(10) revealed that people's psychological stress under COVID-19 directly affected their quality of life and work performance.…”