Intravenous Thrombolysis for Acute Ischemic Stroke during the COVID-19 Pandemic—Polish Single-Center Retrospective Cohort Study

• Published in: Life (Basel, Switzerland) Vol. 12; no. 7; p. 1068
• Main Authors: Chmiela, Tomasz, Rzepka, Michalina, Kuca, Maciej, Serwońska, Karolina, Laskowski, Maciej, Koperczak, Agnieszka, Siuda, Joanna
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 17.07.2022; MDPI
• Subjects: Blood glucose; Cardiac arrhythmia; Cardiovascular diseases; Cohort analysis; Coronary artery disease; Coronaviruses; COVID-19; Diabetes; Disease prevention; Fibrillation; Health services; Heart diseases; Hospitals; Hyperlipidemia; Hypertension; Infections; Intravenous administration; Ischemia; ischemic stroke; Lipids; Pandemics; Patients; Public health; Risk analysis; Risk factors; Severe acute respiratory syndrome coronavirus 2; Software; Statistical analysis; Stroke; Thrombolysis; thrombolytic treatment; United States > US; China
• DOI: 10.3390/life12071068
• ISSN: 2075-1729

COVID-19 has affected the entire world and has had a great impact on healthcare, influencing the treatment of patients with acute ischemic stroke (AIS). The aim of this study was to determine the impact of the COVID-19 pandemic on the care of patients with AIS. We performed a retrospective analysis of 1599 patients diagnosed with AIS and hospitalized in the authors’ institution from January 2018 to December 2021. The final sample consisted of 265 patients treated with thrombolysis without a diagnosis of COVID-19. The initiation of thrombolytic treatment during the pandemic was delayed (2:42 ± 0:51 vs. 2:25 ± 0:53; p = 0.0006). The delay was mainly related to the pre-hospital phase (1:41 ± 0:48 vs. 1:26 ± 0:49; p = 0.0014), and the door-to-needle time was not affected. There were no differences in stroke severity and patients’ outcomes. Patients with AIS were less likely to have previously been diagnosed with atrial fibrillation (16.9% vs. 26.7%; p = 0.0383), ischemic heart disease (25.3% vs. 46.5%; p = 0.0003) and hyperlipidemia (31.2% vs. 46.5%; p = 0.0264). Patients treated during the pandemic had higher glycemia (149.45 ± 54. vs. 143.25 ± 60.71 mg/dL; p= 0.0012), while no significant differences in their lipid profiles were found. Conclusions: The COVID-19 pandemic affected the treatment of AIS patients locally at our stroke center. It caused treatment delay and hindered the recognition of risk factors prior to the occurrence of AIS.