Intravenous Thrombolysis for Acute Ischemic Stroke during COVID‐19 Pandemic in Srinagarind Hospital

Jetsada Bubpharat¹, Somsak Tiamkao^2,3

Affiliation : ¹ Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, ² Division of Neurology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, ³ Integrated Epilepsy Research Group, Khon Kaen University, Khon Kaen, Thailand

Background: Stroke is the leading cause of death and disability worldwide. In COVID-19 pandemic, stroke remains to be a medical emergency. To treat patients with acute ischemic stroke (AIS), early intravenous thrombolysis is highly time sensitive. This research investigated the impact of regionally imposed social and healthcare restrictions of COVID-19 on the time metrics in the management of AIS patients admitted at the stroke unit center in Srinagarind Hospital.
Objective: Comparison of door to needle time for intravenous thrombolysis for AIS patients before and after the COVID-19 outbreak.
Materials and Methods: The present study is a retrospective analysis of patients with AIS who received intravenous tissue plasminogen activator (tPA) from 1 January 2019 to 31 December 2020 in Srinagarind Hospital, Khon Kaen. The patients admitted before and after the COVID-19 outbreak (January 13, 2020, as officially announced by the World Health Organization) were screened to collect sociodemographic data, medical history information, and symptom onset status from clinical medical records and to compared door-to-needle time (DNT) for intravenous thrombolysis before and after the outbreak.
Results: A total of 239 patients were included, of which 113 were enrolled before and 126 after the COVID-19 outbreak. According to the findings, DNT is 35.3 minutes before the pandemic and 35.8 minutes after the epidemic.
Conclusion: COVID-19 has remarkable impacts on the management of AIS. However, DNT for before and after COVID-19 outbreak is nearly identical. It was established that administering intravenous thrombolysis to patients in the emergency room rather than the stroke unit allowed for speedier access. Therefore, a policy which provides quick AIS treatments in COVID-19 situations should be implemented.

DOI:10.35755/jmedassocthai.2023.S01.13760

Keywords : Acute stroke; COVID-19; Intravenous thrombolysis; Door-to-needle time

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