Related Experiment Video
Updated: Nov 20, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Care Process of Recanalization Therapy for Acute Stroke during the COVID-19 Outbreak in South Korea
Young Dae Kim1,2, Hyo Suk Nam1,2, Sung Il Sohn3
1Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
Insights
During the COVID-19 outbreak, acute stroke patients experienced longer prehospital delays and were more likely to go home. This highlights the need for improved prehospital care and patient engagement during pandemics.
Area of Science:
- Neurology
- Public Health
- Infectious Diseases
Background:
- The coronavirus disease 2019 (COVID-19) pandemic significantly impacted healthcare systems globally.
- Understanding its effect on acute stroke care, particularly recanalization therapy, is crucial for maintaining optimal patient outcomes.
Purpose of the Study:
- To investigate changes in the care process and outcomes for acute stroke patients receiving recanalization therapy during the COVID-19 outbreak in South Korea.
- To compare pre- and during-outbreak data to identify specific impacts of the pandemic on stroke treatment.
Main Methods:
- Utilized data from a prospective multicenter reperfusion therapy registry.
- Compared key care process metrics (e.g., time from symptom onset to treatment, patient numbers, discharge disposition) and treatment outcomes before and during the COVID-19 outbreak.
- Analyzed statistical significance of observed changes.
Main Results:
- A temporary decrease in endovascular treatment for acute stroke was observed during the COVID-19 outbreak.
- Increased use of emergency medical services (EMS) and a significant delay in symptom onset to hospital visit time were noted.
- More functionally dependent patients were discharged home, while in-hospital treatment times and functional outcomes remained unchanged.
- No significant changes were found in successful recanalization rates or symptomatic intracerebral hemorrhage.
Conclusions:
- The COVID-19 outbreak was associated with prehospital delays in acute stroke care, potentially due to patient reluctance to seek hospital care.
- Findings underscore the importance of addressing prehospital care and patient behavior during public health emergencies like the COVID-19 pandemic.
- Maintaining timely access to stroke recanalization therapy requires targeted interventions during pandemics.
Background And Purpose:
We aimed to determine whether the care process and outcomes in patients with acute stroke who received recanalization therapy changed during the outbreak of coronavirus disease 2019 (COVID-19) in South Korea.
Methods:
We used data from a prospective multicenter reperfusion therapy registry to compare the care process-including the time from symptom onset to treatment, number of treated patients, and discharge disposition-and treatment outcomes between before and during the COVID-19 outbreak in South Korea.
Results:
Upon the COVID-19 outbreak in South Korea, the number of patients receiving endovascular treatment to decrease temporarily but considerably. The use of emergency medical services by stroke patients increased from 91.5% before to 100.0% during the COVID-19 outbreak (p=0.025), as did the median time from symptom onset to hospital visit [median (interquartile range), 91.0 minutes (39.8-277.0) vs. 176.0 minutes (56.0-391.5), p=0.029]. Furthermore, more functionally dependent patients with disabilities were discharged home (59.5% vs. 26.1%, p=0.020) rather than staying in a regional or rehabilitation hospital. In contrast, there were no COVID-19-related changes in the times from the hospital visit to brain imaging and treatment or in the functional outcome, successful recanalization rate, or rate of symptomatic intracerebral hemorrhage.
Conclusions:
These findings suggest that a prehospital delay occurred during the COVID-19 outbreak, and that patients with acute stroke might have been reluctant to visit and stay in hospitals. Our findings indicate that attention should be paid to prehospital care and the behavior of patients with acute stroke during the COVID-19 outbreak.
