Impact of Coronavirus Disease 2019 on Time Delay and Functional Outcome of Mechanical Thrombectomy in Tokyo, Japan

• Published in: Journal of stroke and cerebrovascular diseases Vol. 30; no. 10; p. 106051
• Main Authors: Katsumata, Masahiro, Ota, Takahiro, Kaneko, Junya, Jimbo, Hiroyuki, Aoki, Rie, Fujitani, Shigeta, Ichijo, Masahiko, Inoue, Masato, Shigeta, Keigo, Miyauchi, Yoshifumi, Sakai, Yu, Arakawa, Hideki, Otsuka, Yoshinobu, Ariyada, Kenichi, Kuroshima, Yoshiaki, Fuse, Takahisa, Shiokawa, Yoshiaki, Hirano, Teruyuki
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2021
• Subjects: Acute ischemic stroke; COVID-19; Epidemiology; Health Care Rationing - trends; Health Services Needs and Demand - trends; Humans; Practice Patterns, Physicians' - trends; Registries; Retrospective Studies; Stroke - diagnosis; Stroke - therapy; Thrombectomy; Thrombectomy - trends; Time Factors; Time-to-Treatment - trends; Tokyo; Treatment Outcome; Tokyo; COVID-19; Thrombectomy; Acute ischemic stroke; Epidemiology
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2021.106051

•O2D time for MT may have been affected by COVID-19.•D2P time and functional outcome did not significantly differ between 2019 and 2020.•MT may be well performed despite COVID-19 pandemic.•COVID-19: coronavirus disease 2019, MT: mechanical thrombectomy, O2D: onset to door, D2P: door to puncture An association has been reported between delays in the onset-to-door (O2D) time for mechanical thrombectomy (MT) and outbreaks of coronavirus disease 2019 (COVID-19). However, the association between other MT time courses or functional outcomes and COVID-19 outbreaks remains unclear. We compared the time courses of stroke pathways or functional outcomes in 2020 (the COVID-19 era) with those in 2019 (the pre-COVID-19 era) in Tokyo, Japan. This retrospective observational study used data from the Tokyo-tama-REgistry of Acute endovascular Thrombectomy (TREAT), a multicenter registry of MT for acute large vessel occlusion in the Tokyo Metropolitan Area. Patients who had undergone acute MT from January 2019 to December 2020 were included. Patients were classified by the year they had undergone MT (2019 or 2020). In total, 477 patients were analyzed. O2D time was significantly longer in 2020 (146.0 min) than in 2019 (105.0 min; p = 0.034). No significant difference in door-to-puncture time (D2P) time or modified Rankin Scale (mRS) score 0–2 at 90 days was seen between 2019 and 2020. In the subgroup analysis, O2D time was significantly longer in the first half of 2020 compared with 2019. Multivariable logistic regression analysis revealed that the year 2020 was a independent predictor of longer O2D time, but not for mRS score 0–2 at 90 days. Although O2D time was significantly longer in the COVID-19 compared with the pre-COVID-19 era, D2P may not be significantly delayed and functional outcomes may not be different, despite the COVID-19 pandemic.