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Cardiovascular & Hematological Disorders-Drug Targets

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ISSN (Print): 1871-529X
ISSN (Online): 2212-4063

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Research Article

Outcome After Acute Ischemic Stroke Treatment During Covid-19 Outbreak in South-East Tuscany

Author(s): Maurizio Acampa*, Valentina Peresso, Pietro Enea Lazzerini, Carlo Domenichelli, Francesca Guideri, Rossana Tassi, Stefano Dami, Roberto Marconi, Giovanni Iannelli, Giovanni Linoli, Giulia Peppoloni, Simone Nocentini, Simone Gallerini, Alessandra Cartocci, Sandra Bracco and Giuseppe Martini

Volume 21, Issue 3, 2021

Published on: 27 September, 2021

Page: [179 - 184] Pages: 6

DOI: 10.2174/1871529X21666210927094058

Price: $65

Abstract

Background: During Covid-19 pandemic, the Italian National Healthcare Service has faced increasing pressure, especially in Northern Italy. Even in less-affected regions, such as Tuscany, the changes in the healthcare system to prevent Covid-19 spread resulted in difficulty in treating time-dependent disorders like ischemic stroke rapidly.

Objective: The aim of our study was to assess the outcome after acute ischemic stroke treatments during the Covid-19 spread in comparison with a similar period of the previous year in Siena-Hospital (Hub center in the South-East Tuscany).

Methods: We enrolled all patients admitted to Siena-Hospital for ischemic stroke and submitted them to acute treatments (intravenous and/or mechanical thrombolysis) between February 21st and May 18th, 2020 (study group, n:38) and compared the results with ischemic strokes acutely treated in a similar period in 2019 (control group, n:39). The modified Rankin scale score was assessed at 90 days to evaluate a 3-month clinical outcome.

Results: In the study group, the time from symptoms onset to hospital arrival and the door-to-groin puncture time were significantly more prolonged than in the control group. In moderate-severe strokes, the 3-month mortality was significantly higher in the study group (31% vs. 6%; p=0.01), and the number of patients with poor functional outcomes was significantly higher in the study group (73% vs. 44%; p=0.03).

Conclusion: During the lockdown period due to Covid-19 pandemic, patients with acute ischemic stroke had a worse prognosis. These findings suggest the need to improve the health system organization to guarantee an appropriate treatment during the pandemic, including the patients that are not affected by Covid-19.

Keywords: Ischemic stroke, thrombolysis, alteplase, mechanical thrombolysis, COVID-19, treatment outcome.

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[1]
Armocida, B.; Formenti, B.; Ussai, S.; Palestra, F.; Missoni, E. The Italian health system and the COVID-19 challenge. Lancet Public Health, 2020, 5(5), e253.
[http://dx.doi.org/10.1016/S2468-2667(20)30074-8] [PMID: 32220653]
[2]
Bersano, A.; Pantoni, L. Stroke care in Italy at the time of the COVID-19 pandemic: A lesson to learn. J. Neurol., 2020, 268, 2307-2313.
[http://dx.doi.org/10.1007/s00415-020-10200-2] [PMID: 32954445]
[3]
Adams, H.P., Jr; Bendixen, B.H.; Kappelle, L.J.; Biller, J.; Love, B.B.; Gordon, D.L.; Marsh, E.E., III Classification of subtype of acute ischemic stroke. definitions for use in a multicenter clinical trial. toast. trial of org 10172 in acute stroke treatment. Stroke, 1993, 24(1), 35-41.
[http://dx.doi.org/10.1161/01.STR.24.1.35] [PMID: 7678184]
[4]
Powers, W.J.; Rab.instein, A.A.; Ackerson, T.; Adeoye, O.M.; Bambakidis, N.C.; Becker, K.; Biller, J.; Brown, M.; Demaerschalk, B.M.; Hoh, B.; Jauch, E.C.; Kidwell, C.S.; Leslie-Mazwi, T.M.; Ovbiagele, B.; Scott, P.A.; Sheth, K.N.; Southerland, A.M.; Summers, D.V.; Tirschwell, D.L. 2018 Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the american heart association/american stroke association. Stroke, 2018, 49, e46-e110.
[http://dx.doi.org/10.1161/STR.0000000000000158] [PMID: 29367334]
[5]
English, J.D.; Yavagal, D.R.; Gupta, R.; Janardhan, V.; Zaidat, O.O.; Xavier, A.R.; Nogueira, R.G.; Kirmani, J.F.; Jovin, T.G. Mechanical thrombectomy-ready comprehensive stroke center requirements and endovascular stroke systems of care: recommendations from the endovascular stroke standards committee of the society of vascular and interventional neurology (SVIN). Intervent. Neurol., 2016, 4(3-4), 138-150.
[http://dx.doi.org/10.1159/000442715] [PMID: 27051410]
[6]
Schirmer, C.M.; Ringer, A.J.; Arthur, A.S.; Binning, M.J.; Fox, W.C.; James, R.F.; Levitt, M.R.; Tawk, R.G.; Veznedaroglu, E.; Walker, M.; Spiotta, A.M. Delayed presentation of acute ischemic strokes during the covid-19 crisis. J. Neurointerv. Surg., 2020, 12(7), 639-642.
[http://dx.doi.org/10.1136/neurintsurg-2020-016299] [PMID: 32467244]
[7]
Baldi, E.; Savastano, S. Fear of contagion: one of the most devious enemies to fight during the covid-19 pandemic. Disaster Med. Public Health Prep., 2020, 1-2, 1-2.
[http://dx.doi.org/10.1017/dmp.2020.338] [PMID: 32907670]
[8]
Paoli, A.; Brischigliaro, L.; Scquizzato, T.; Favaretto, A.; Spagna, A. Out-of-hospital cardiac arrest during the covid-19 pandemic in the province of padua, northeast italy. Resuscitation, 2020, 154, 47-49.
[http://dx.doi.org/10.1016/j.resuscitation.2020.06.031] [PMID: 32653572]
[9]
Baldi, E.; Sechi, G.M.; Mare, C.; Canevari, F.; Brancaglione, A.; Primi, R.; Klersy, C.; Palo, A.; Contri, E.; Ronchi, V.; Beretta, G.; Reali, F.; Parogni, P.; Facchin, F.; Rizzi, U.; Bussi, D.; Ruggeri, S.; Oltrona Visconti, L.; Savastano, S. COVID-19 kills at home: the close relationship between the epidemic and the increase of out-of-hospital cardiac arrests. Eur. Heart J., 2020, 41(32), 3045-3054.
[http://dx.doi.org/10.1093/eurheartj/ehaa508] [PMID: 32562486]
[10]
Richter, D.; Eyding, J.; Weber, R.; Bartig, D.; Grau, A.; Hacke, W.; Krogias, C. Analysis of nationwide stroke patient care in times of covid-19 pandemic in germany. Stroke, 2021, 52(2), 716-721.
[http://dx.doi.org/10.1161/STROKEAHA.120.033160] [PMID: 33356382]
[11]
Sacco, S.; Ricci, S.; Ornello, R.; Eusebi, P.; Petraglia, L.; Toni, D. Reduced admissions for cerebrovascular events during covid-19 outbreak in italy. Stroke, 2020, 51(12), 3746-3750.
[http://dx.doi.org/10.1161/STROKEAHA.120.031293] [PMID: 33059543]
[12]
Siegler, J.E.; Zha, A.M.; Czap, A.L.; Ortega-Gutierrez, S.; Farooqui, M.; Liebeskind, D.S.; Desai, S.M.; Hassan, A.E.; Starosciak, A.K.; Linfante, I.; Rai, V.; Thon, J.M.; Then, R.; Heslin, M.E.; Thau, L.; Khandelwal, P.; Mohammaden, M.H.; Haussen, D.C.; Nogueira, R.G.; Jillella, D.V.; Nahab, F.; Kaliaev, A.; Nguyen, T.N.; Zaidat, O.; Jovin, T.G.; Jhadav, A.P. Influence of the covid-19 pandemic on treatment times for acute ischemic stroke: the society of vascular and interventional neurology multicenter collaboration. Stroke, 2021, 52(1), 40-47.
[http://dx.doi.org/10.1161/STROKEAHA.120.032789] [PMID: 33250041]
[13]
Nguyen, T.N.; Abdalkader, M.; Jovin, T.G.; Nogueira, R.G.; Jadhav, A.P.; Haussen, D.C.; Hassan, A.E.; Novakovic, R.; Sheth, S.A.; Ortega-Gutierrez, S.; Panagos, P.D.; Cordina, S.M.; Linfante, I.; Mansour, O.Y.; Malik, A.M.; Narayanan, S.; Masoud, H.E.; Chou, S.H.; Khatri, R.; Janardhan, V.; Yavagal, D.R.; Zaidat, O.O.; Greer, D.M.; Liebeskind, D.S. Mechanical thrombectomy in the era of the covid-19 pandemic: emergency preparedness for neuroscience teams: a guidance statement from the society of vascular and interventional neurology. Stroke, 2020, 51(6), 1896-1901.
[http://dx.doi.org/10.1161/STROKEAHA.120.030100] [PMID: 32347790]

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