Temporal analysis of the administration of encephalic reperfusion therapies during the COVID-19 pandemic in a Chilean hospital: An analytical cross-sectional study.

Abstract

Introduction: The COVID-19 pandemic had a major impact on emergency services, including stroke care. Changes in the administration times of brain reperfusion therapies for stroke have been little explored in Chile. The aim of this study was to analyze the impact that the pandemic had on critical stroke treatment times, the number of patients treated, clinical severity, and the presence of major vessel occlusion.

Methods: We performed a retrospective analysis of patients undergoing encephalic reperfusion therapy in a hospital in Valparaíso, Chile. Two groups of patients treated one year before (pre-pandemic group) and one year after (pandemic group) the start of health restrictions were compared.

Results: 104 patients were included, with a mean age of 67.4 ± 13 years and a clinical severity of 13.5 ± 6.5 in the NIHSS. 91.5% received thrombolytic therapy. No significant intergroup differences were found in the metrics of treatment time, number of patients treated, clinical severity, or presence of major vessel occlusion. Although there was a non-significant trend towards delayed institutional therapeutic times, a significant correlation was found suggesting that the shorter the time from symptom onset to door, the shorter the time to access therapy (r = 0.84).

Conclusions: There were no significant differences in the therapeutic times of stroke in the period prior to the COVID-19 pandemic and the pandemic period, showing similarities to the experience reported in Chile and highlighting the adaptation of the health system during the health crisis. Studies with more complex epidemiological designs analyzing larger samples of patients will allow us to complement these results.