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Updated: Dec 14, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Impact of the COVID-19 outbreak on acute stroke care
L A Rinkel1, J C M Prick2, R E R Slot3
1Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands.
Insights
The COVID-19 outbreak saw a 24% decrease in suspected stroke admissions. However, the quality of acute stroke care, including reperfusion therapy and treatment times, remained unaffected during this period.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- Concerns exist regarding the impact of the coronavirus disease 2019 (COVID-19) on acute cardiovascular care.
- The COVID-19 pandemic may have altered healthcare-seeking behaviors and hospital workflows for acute conditions.
Purpose of the Study:
- To assess the effect of the COVID-19 outbreak on hospital admission trends for acute stroke.
- To evaluate changes in workflow parameters and quality of care for acute stroke patients during the COVID-19 pandemic in Amsterdam.
Main Methods:
- Retrospective analysis of stroke patient data from three Amsterdam hospitals.
- Comparison of two 7-week periods: pre-COVID-19 (Oct-Dec 2019) and peak COVID-19 (Mar-May 2020).
- Incidence-rate ratios (IRR) were calculated for patient numbers, stroke subtypes, reperfusion therapy use, treatment times, and complications.
Main Results:
- A 24% decrease in suspected stroke presentations was observed during the COVID-19 period (IRR 0.76).
- The proportion of male patients presenting with stroke increased during the COVID-19 outbreak.
- No significant changes were found in the use of intravenous thrombolysis or endovascular thrombectomy, nor in associated treatment times or in-hospital complications.
Conclusions:
- Despite a significant reduction in stroke presentations during the COVID-19 outbreak, the quality of acute stroke care was maintained.
- This suggests that established protocols for acute stroke management were resilient during the pandemic.
Background And Purpose:
There are concerns that the coronavirus disease 2019 (COVID-19) outbreak negatively affects the quality of care for acute cardiovascular conditions. We assessed the impact of the COVID-19 outbreak on trends in hospital admissions and workflow parameters of acute stroke care in Amsterdam, The Netherlands.
Methods:
We used data from the three hospitals that provide acute stroke care for the Amsterdam region. We compared two 7-week periods: one during the peak of the COVID-19 outbreak (March 16th-May 3th 2020) and one prior to the outbreak (October 21st-December 8th 2019). We included consecutive patients who presented to the emergency departments with a suspected stroke and assessed the change in number of patients as an incidence-rate ratio (IRR) using a Poisson regression analysis. Other outcomes were the IRR for stroke subtypes, change in use of reperfusion therapy, treatment times, and in-hospital complications.
Results:
During the COVID-19 period, 309 patients presented with a suspected stroke compared to 407 patients in the pre-COVID-19 period (IRR 0.76 95%CI 0.65-0.88). The proportion of men was higher during the COVID-19 period (59% vs. 47%, p < 0.001). There was no change in the proportion of stroke patients treated with intravenous thrombolysis (28% vs. 30%, p = 0.58) or endovascular thrombectomy (11% vs 12%, p = 0.82) or associated treatment times. Seven patients (all ischemic strokes) were diagnosed with COVID-19.
Conclusion:
We observed a 24% decrease in suspected stroke presentations during the COVID-19 outbreak, but no evidence for a decrease in quality of acute stroke care.
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