BACKGROUND AND PURPOSE: In a comprehensive stroke center, we analyzed the stroke code activations (SCA), assessed the impact of Covid-19, and the measures taken by the local government to lessen the spread of the disease. METHODS: We retrospectively reviewed SCA and classified them into 2 groups: pre-pandemic activations (February 15 to March 10) and Covid-19 pandemic activations (March 11 to April 30). The primary outcome was the ratio of true positive diagnoses of stroke relative to the total number of SCA in the 2 time periods. RESULTS: Among the 212 SCA, 83 (39.2%) were from the pre-pandemic period, whereas 129 (60.8%) were from the pandemic period, 147 (69.3%) in the Emergency Department (ED) versus 65 (30.7%) in the inpatient service. In the ED cohort, a rapid decrease in the number of SCA at the beginning of the pandemic was followed by a gradual increase to pre-pandemic levels and a significant increase in the number of true positive strokes over time (44.2% vs 61.1%, p = 0.037). An increase in door-to-CT time (p = 0.001) and an increase in the rate of diagnostic error in patients admitted from the ED (p = 0.016) were also seen. The in-hospital cohort had a sustained decrease in the number of SCA following the pandemic declaration, with no difference in the rate of true positive stroke. CONCLUSIONS: We observed a rapid decline and slow recovery in ED SCA with a shift toward increased true positive cases following the Covid-19 pandemic. Also, delays in obtaining CT and diagnostic error was increased, however, no difference in early clinical outcomes were seen between groups.
BACKGROUND AND PURPOSE: In a comprehensive stroke center, we analyzed the stroke code activations (SCA), assessed the impact of Covid-19, and the measures taken by the local government to lessen the spread of the disease. METHODS: We retrospectively reviewed SCA and classified them into 2 groups: pre-pandemic activations (February 15 to March 10) and Covid-19 pandemic activations (March 11 to April 30). The primary outcome was the ratio of true positive diagnoses of stroke relative to the total number of SCA in the 2 time periods. RESULTS: Among the 212 SCA, 83 (39.2%) were from the pre-pandemic period, whereas 129 (60.8%) were from the pandemic period, 147 (69.3%) in the Emergency Department (ED) versus 65 (30.7%) in the inpatient service. In the ED cohort, a rapid decrease in the number of SCA at the beginning of the pandemic was followed by a gradual increase to pre-pandemic levels and a significant increase in the number of true positive strokes over time (44.2% vs 61.1%, p = 0.037). An increase in door-to-CT time (p = 0.001) and an increase in the rate of diagnostic error in patients admitted from the ED (p = 0.016) were also seen. The in-hospital cohort had a sustained decrease in the number of SCA following the pandemic declaration, with no difference in the rate of true positive stroke. CONCLUSIONS: We observed a rapid decline and slow recovery in ED SCA with a shift toward increased true positive cases following the Covid-19 pandemic. Also, delays in obtaining CT and diagnostic error was increased, however, no difference in early clinical outcomes were seen between groups.
Authors: Ralph L Sacco; Scott E Kasner; Joseph P Broderick; Louis R Caplan; J J Buddy Connors; Antonio Culebras; Mitchell S V Elkind; Mary G George; Allen D Hamdan; Randall T Higashida; Brian L Hoh; L Scott Janis; Carlos S Kase; Dawn O Kleindorfer; Jin-Moo Lee; Michael E Moseley; Eric D Peterson; Tanya N Turan; Amy L Valderrama; Harry V Vinters Journal: Stroke Date: 2013-05-07 Impact factor: 7.914
Authors: Victor J Del Brutto; Agnieszka Ardelt; Andrea Loggini; Zachary Bulwa; Faten El-Ammar; Raisa C Martinez; James Brorson; Fernando Goldenberg Journal: J Stroke Cerebrovasc Dis Date: 2019-03-04 Impact factor: 2.136
Authors: Ken Uchino; Murali K Kolikonda; Dena Brown; Shivakrishna Kovi; Dana Collins; Zeshaun Khawaja; A Blake Buletko; Andrew N Russman; M Shazam Hussain Journal: Stroke Date: 2020-06-18 Impact factor: 7.914
Authors: Kay-Cheong Teo; William C Y Leung; Yuen-Kwun Wong; Roxanna K C Liu; Anna H Y Chan; Olivia M Y Choi; Wing-Man Kwok; Kung-Ki Leung; Man-Yu Tse; Raymond T F Cheung; Anderson Chun-On Tsang; Kui Kai Lau Journal: Stroke Date: 2020-05-20 Impact factor: 7.914
Authors: Isaac Ghinai; Tristan D McPherson; Jennifer C Hunter; Hannah L Kirking; Demian Christiansen; Kiran Joshi; Rachel Rubin; Shirley Morales-Estrada; Stephanie R Black; Massimo Pacilli; Marielle J Fricchione; Rashmi K Chugh; Kelly A Walblay; N Seema Ahmed; William C Stoecker; Nausheen F Hasan; Deborah P Burdsall; Heather E Reese; Megan Wallace; Chen Wang; Darcie Moeller; Jacqueline Korpics; Shannon A Novosad; Isaac Benowitz; Max W Jacobs; Vishal S Dasari; Megan T Patel; Judy Kauerauf; E Matt Charles; Ngozi O Ezike; Victoria Chu; Claire M Midgley; Melissa A Rolfes; Susan I Gerber; Xiaoyan Lu; Stephen Lindstrom; Jennifer R Verani; Jennifer E Layden Journal: Lancet Date: 2020-03-13 Impact factor: 79.321
Authors: Adam S Jasne; Pola Chojecka; Ilavarasy Maran; Razaz Mageid; Mohamed Eldokmak; Qiang Zhang; Karin Nystrom; Kelsey Vlieks; Michael Askenase; Nils Petersen; Guido J Falcone; Charles R Wira; Paul Lleva; Neer Zeevi; Reshma Narula; Hardik Amin; Dhasakumar Navaratnam; Caitlin Loomis; David Y Hwang; Joseph Schindler; Ryan Hebert; Charles Matouk; Harlan M Krumholz; Serena Spudich; Kevin N Sheth; Lauren H Sansing; Richa Sharma Journal: Stroke Date: 2020-07-31 Impact factor: 7.914