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PRESERVATION OF QUALITY OF ACUTE STROKE CARE DURING THE COVID-19 PANDEMIC IN THE LARGEST SOUTH AMERICAN HOSPITAL
Abstract
Background and Aims
The COVID-19 pandemic increased the burden on emergency neurologists and posed big challenges to acute stroke treatment. The workflow for stroke treatment was suddenly changed at Hospital das Clinicas/Sao Paulo University, the largest hospital in South America, due to the pandemic. From March 30 until August,2020, he worflow for acute stroke treatment underwent major changes and the Neurology team had to adapt to the new setting. We hypothesized that door-to-imaging and door-to-needle times would increase from April-August, 2019 (Pre-COVID) to April-August, 2020 (Post-COVID).
Methods
Data were prospectively collected as part of the Hospital das Clínicas Stroke Database project. We analyzed age, gender, NIH stroke scale, door-to-imaging and door-to-needle times for patients treated with thrombolysis within the Pre-COVID and Post-COVID periods. The data were compared with unpaired t-tests or Mann-Whitney tests.
Results
The number of intravenous thrombolysis procedures decreased 27%, from 55 (Pre-COVID) to 40 (Post-COVID). There were no significant differences in age, gender, NIH Stroke Scales, door-to-imaging (Pre-COVID: median, 41 minutes; Post-COVID: median, 36 minutes; p=0.796) or door-to-needle times (Pre-COVID: median, 17 minutes; post-COVID: median, 15.5 minutes; p=0.704) between the Pre-COVID and Post-COVID periods.
Conclusions
Contrary to our hypothesis, no significant differences were observed in door-to-imaging or door-to-needle times. These results suggest that an experienced team can quickly adapt to changes in code stroke, and preserve quality of care during the pandemic.