Title
COVID-19 Lockdown Effects on Acute Stroke Care in Latin America
Date Issued
01 September 2021
Access level
open access
Resource Type
journal article
Author(s)
Pujol-Lereis V.A.
Flores A.
Barboza M.A.
Amaya P.
Bayona H.
Bonardo P.
Diaz-Escobar L.
Gomez-Schneider M.
Góngora-Rivera F.
Lavados P.M.
Leon C.
Luraschi A.
Marquez-Romero J.M.
Ouriques-Martins S.C.
Navia V.H.
Ruiz-Franco A.
Zurrú M.C.
Arauz A.
Ameriso S.F.
Publisher(s)
W.B. Saunders
Abstract
Objectives: COVID-19 pandemic has forced important changes in health care worldwide. Stroke care networks have been affected, especially during peak periods. We assessed the impact of the pandemic and lockdowns in stroke admissions and care in Latin America. Materials and Methods: A multinational study (7 countries, 18 centers) of patients admitted during the pandemic outbreak (March-June 2020). Comparisons were made with the same period in 2019. Numbers of cases, stroke etiology and severity, acute care and hospitalization outcomes were assessed. Results: Most countries reported mild decreases in stroke admissions compared to the same period of 2019 (1187 vs. 1166, p = 0.03). Among stroke subtypes, there was a reduction in ischemic strokes (IS) admissions (78.3% vs. 73.9%, p = 0.01) compared with 2019, especially in IS with NIHSS 0–5 (50.1% vs. 44.9%, p = 0.03). A substantial increase in the proportion of stroke admissions beyond 48 h from symptoms onset was observed (13.8% vs. 20.5%, p < 0.001). Nevertheless, no differences in total reperfusion treatment rates were observed, with similar door-to-needle, door-to-CT, and door-to-groin times in both periods. Other stroke outcomes, as all-type mortality during hospitalization (4.9% vs. 9.7%, p < 0.001), length of stay (IQR 1–5 days vs. 0–9 days, p < 0.001), and likelihood to be discharged home (91.6% vs. 83.0%, p < 0.001), were compromised during COVID-19 lockdown period. Conclusions: In this Latin America survey, there was a mild decrease in admissions of IS during the COVID-19 lockdown period, with a significant delay in time to consultations and worse hospitalization outcomes.
Volume
30
Issue
9
Language
English
OCDE Knowledge area
Sistema cardiaco, Sistema cardiovascular
Políticas de salud, Servicios de salud
Neurología clínica
Epidemiología
Subjects
Scopus EID
2-s2.0-85110405012
PubMed ID
Source
Journal of Stroke and Cerebrovascular Diseases
ISSN of the container
10523057
Sponsor(s)
Co‐Investigators and Collaborators of the LASE COVID-19: Matías J. Alet, Julieta S. Rosales (División de Neurología Vascular, Departamento de Neurología, Fleni, Ciudad Autónoma de Buenos Aires, Argentina); Federico Sosa Albacete, Marianela Lopez Armaretti (Servicio de Neurología, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina); María Agustina Piedrabuena (Instituto de Neurología y Neurocirugía. Sanatorio de Los Arcos, Ciudad Autónoma de Buenos Aires, Argentina); Óscar Balaguera-Cala, Victoria González (Unidad de Stroke, Servicio de Neurología, Hospital Pirovano, Ciudad Autónoma de Buenos Aires, Argentina); Lucrecia Noelia Bandeo, Fabio Maximiliano González (Servicio de neurología, Hospital Británico de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina); Matías Guzmán (Unidad de Neurología Vascular, Servicio de Neurología, Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile; Servicio de Neurología, Hospital Padre Hurtado, SSMSO, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo y Santiago, Chile); Verónica V. Olavarría (Unidad de Neurología Vascular, Servicio de Neurología, Departamento de Neurología y Psiquiatría y Departamento de Paciente Critico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile); Juan Almeida (Hospital Padre Hurtado, SSMSO, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile); Cristóbal Abarca; Camila Villafranca (Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile); Eder Moreno (Universidad de Los Andes, Bogotá, Colombia); Akemi Arango (Fundación Clínica Valle del Lili, Cali, Colombia); Diana Manrique, Vanesa Cano-Nigenda, Enrique Castellanos (Clínica de Enfermedad vascular cerebral, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez, Ciudad de México, México); Adrián Infante-Valenzuela, Horacio Chapa-Martínez, Alejandro González-Aquines (Universidad Autónoma de Nuevo León, Servicio de Neurología, Hospital Universitario José Eleuterio González, Monterrey, México); Ricardo Mernes, Christian Otto (Unidad de Ictus, Hospital de Clínicas, FCM UNA, San Lorenzo, Paraguay); Ana María Valencia-Chávez, Danny Barrientos-Imán, Néstor Flores-Rodríguez, Ricardo Otiniano-Sifuentes (Departamento de Enfermedades Neurovasculares, Instituto Nacional de Ciencias Neurológicas, Lima, Perú); José Bejarano-Ferreyra, Jair Mattos-Castillo (Residentado de Neurología, Instituto Nacional de Ciencias Neurológicas, Lima, Perú); Liliana Rodríguez-Kadota (Departamento de Neurología, Hospital Nacional Edgardo Rebagliati Martins, Essalud, Lima, Perú); The author(s) disclosed no receipt of financial support for the research, authorship, and/or publication of this article.
Sources of information:
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Scopus