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Updated: Nov 18, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Mitigating the impact of coronavirus disease 2019 on emergency stroke care: an original study and meta-analysis
Jian Wang1, Ye Hong1, Mengmeng Ma1
1Department of Neurology, West China Hospital of Sichuan University, Wainan Guoxue Xiang #37, Chengdu610041, China.
Insights
The COVID-19 pandemic impacted stroke care, with faster hospital admissions and increased mechanical thrombectomy rates observed during peak epidemic periods. Comprehensive measures are vital for maintaining high-quality stroke emergency services during global health crises.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic significantly disrupted healthcare systems globally.
- Stroke emergency care is time-sensitive and vulnerable to disruptions.
- Understanding pandemic impacts on stroke treatment is crucial for healthcare preparedness.
Purpose of the Study:
- To investigate the impact of the COVID-19 pandemic on stroke treatment in tertiary stroke centers in western China.
- To quantitatively evaluate the worldwide influence of the pandemic on stroke care via meta-analysis.
Main Methods:
- Original study conducted in three tertiary stroke centers in Sichuan, China, comparing pre-, early, peak, and late pandemic periods.
- Single-center analyses in the largest local hospital and a hospital near the epicenter.
- Systematic review of English publications (Dec 2019-July 2020) from PubMed, Embase, and Cochrane Library.
- Fixed- and random-effect meta-analysis to calculate overall rates.
Main Results:
- Original study showed reduced hospital admission times and higher mechanical thrombectomy rates during early/peak pandemic periods compared to pre-pandemic.
- The largest hospital reported higher mechanical thrombectomy rates throughout the pandemic and fewer daily admissions during early/peak periods.
- Hospital near epicenter showed increased intravenous thrombolysis post-outbreak and better reperfusion outcomes compared to later periods (P<0.05).
- Meta-analysis revealed significant differences in reperfusion therapies and stroke severity across studies, but pooled results were non-significant.
Conclusions:
- The pandemic altered stroke treatment dynamics, necessitating faster interventions like mechanical thrombectomy.
- Hospitals, especially those near epicenters, adapted stroke care protocols with varying success.
- Implementing comprehensive strategies is essential to ensure sustained high-quality stroke emergency care during global health crises.
Abstract:
The coronavirus disease 2019 is still continuing and may affect stroke emergency care. We aim to investigate the impact of pandemic on stroke treatment in tertiary stroke centers in western China, and to quantitatively evaluate the worldwide influence with a meta-analysis. The original part was conducted in three tertiary stroke centers in Sichuan province. We compared emergency visits and efficiency of stroke treatment pre-, early, peak and late pandemic. Single-center analysis was further conducted in the largest local hospital and one hospital located close to the epicenter respectively. Relevant studies were searched in PubMed, Ovid Embase and Cochrane Library for English publications from December 2019 to July 2020 for systematic review. Fixed-and random-effect meta-analysis was performed to calculate the overall rates. Totally current original study showed fewer time of hospital admission and significantly higher rates of mechanical thrombectomy during the early and peak epidemic periods, compared with pre-epidemic time. The largest local hospital had significantly higher mechanical thrombectomy rates during the whole crisis and less daily admission during early and peak epidemic periods. The hospital located close to the epicenter presented higher proportions of intravenous thrombolysis since outbreak, and more favorable outcomes after reperfusion therapies than later (all P values <0.05). In meta-analysis, studies reported differences in reperfusion therapies and stroke severity but pooled results were non-significant. Overall, comprehensive measures should be implemented to keep hospital's capacity to deliver high-quality stroke emergency care during the global pandemic. Some key messages were provided for medical practice in the crisis.
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