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Global Impact of COVID-19 on Stroke Care and IV Thrombolysis
(2021)
Raul G. Nogueira
;
Muhammad M. Qureshi
;
Mohamad Abdalkader
;
Sheila Ouriques Martins
;
Hiroshi Yamagami
Scopus© Citations 87 9
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Abstract P385: Stroke-Related Hospital Admissions During Covid-19 Pandemic in the Latin American Stroke Registry (LASE)
(2021)
Virginia Pujol-Lereis
;
Alan Flores
;
Antonio Arauz
;
Carlos Abanto-Argomedo
;
Pablo Amaya
<jats:p> <jats:bold>Background:</jats:bold> COVID-19 pandemic has forced important changes in health care worldwide. Stroke care networks have been affected, especially acute admissions and ancillary tests availability. We assessed the impact of the pandemic and the lockdowns imposed in stroke admissions in Latin America. </jats:p> <jats:p> <jats:bold>Methods:</jats:bold> A multinational study (7 countries, 18 centers) of patients admitted since the pandemic outbreak (January - June 2020). These cases were compared with the same period in 2019. We also assessed patterns during the strictest lockdown period (March-June 2020). Number of cases, stroke etiology and severity, acute care and functional outcomes were compared per periods, months, centers and countries. </jats:p> <jats:p> <jats:bold>Results:</jats:bold> There were 1863 stroke cases in 2019 and 1781 cases in 2020 (p=0.02). We found a significant increase in strokes of undetermined etiology due to incomplete studies in 2020 [16.8% vs 27.6%, p<0.001]). Most countries reported decreases in all-type stroke admissions, except México and Brasil (16% and 36% increases in admissions, respectively). There were no significant differences among months. All-type mortality increased (6.2% vs. 12.6%, p<0.001), and poor functional outcome (mRs 3-6) increased from 32.2% to 38.8% (p=0.007) in 2020. During the period of strict lockdown (March-June 2020), ischemic stroke admissions during the first 24 hours of onset (68.3% vs. 64.4%, p=0.1) and in-hospital stroke code activation (35.1% vs. 27.6%, p=0.005) diminished compared to 2019 period. No differences in total reperfusion treatment rates were observed, with similar door-to-needle and door-to-groin times in both periods. </jats:p> <jats:p> <jats:bold>Conclusions:</jats:bold> All-type stroke admissions diminished only slightly during the first months of the COVID-19 pandemic. However, in this region, we found substantial deficiencies in stroke work-up, poor short-term outcome and increased mortality. </jats:p>
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Abstract P84: Covid-19 and Stroke in the Latin American Stroke Registry (LASE)
(2021)
Virginia Pujol-Lereis
;
Alan F Flores
;
Antonio Arauz
;
Carlos Abanto
;
Pablo Amaya
<jats:p> <jats:bold>Background:</jats:bold> Ischemic stroke has been reported to occur in approximately 5% of COVID-19 patients, although some reports are contradictory. Proposed mechanisms of this association are hypercoagulable state, vasculitis and cardiomyopathy, together with traditional vascular risk factors. We analyzed the frequency and clinical characteristics of COVID-19 positive stroke cases during the first months of the pandemic in Latin America. </jats:p> <jats:p> <jats:bold>Methods:</jats:bold> A multinational study (7 countries, 18 centers) of patients admitted during the pandemic outbreak (March - June 2020). We assessed acute stroke cases associated to COVID-19 infection. Clinical characteristics, stroke etiology and severity, acute care and functional outcomes, were compared between non-COVID-19 and COVID-19 cases. </jats:p> <jats:p> <jats:bold>Results:</jats:bold> There were a total of 1037 stroke cases; sixty-two of them (6.0%) were diagnosed with COVID-19 infection. This group consisted of 38 men [61.3%], with a median age of 68 years [IQR 59-79 years]. From these cases, 80.6% were ischemic stroke, 16.1% hemorrhagic stroke, and 1.6% transient ischemic attack and cerebral venous thrombosis respectively. The most common etiology reported for ischemic cases was atherosclerotic large vessel occlusion (30.6% vs. 12.7% in non-COVID cases, p<0.001), and undetermined etiology for hemorrhagic stroke (55.6%). Median NIHSS for COVID-stroke patients was higher (7 IQR 2-16 vs. 5 IQR 2-11, p=0.05). Five (8.1%) patients received acute reperfusion therapy, with no differences in door-to-CT, door-to-needle and door-to-groin times, compared to non-COVID cases. Most characteristics did not differ from those of COVID-19 negative patients. Mortality was higher in COVID-stroke cases (20.9% vs. 9.6%, p<0.001). </jats:p> <jats:p> <jats:bold>Conclusions:</jats:bold> COVID-19 infection frequency in stroke patients in Latin America is similar to that reported in several series worldwide, with a higher frequency of atherosclerotic ischemic strokes and mortality compared to non COVID-19 strokes </jats:p>
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COVID-19 Lockdown Effects on Acute Stroke Care in Latin America
(2021)
Virginia A. Pujol-Lereis
;
Alan Flores
;
Miguel A. Barboza
;
Carlos Abanto-Argomedo
;
Pablo Amaya
Scopus© Citations 12 4

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