Delays in thrombolysis during COVID-19 are associated with worse neurological outcomes: the Society of Vascular and Interventional Neurology Multicenter Collaboration

• DOI: 10.1007/s00415-021-10734-z
• Publication Date: 2021-07-31T18:02:48Z
• Authors: Dinesh V. Jillella; Fadi Nahab; Thanh N. Nguyen; Mohamad Abdalkader; David S. Liebeskind; Nirav Vora; Vivek Rai; Diogo C. Haussen; Raul G. Nogueira; Shashvat Desai; Ashutosh P. Jadhav; Alexandra L. Czap; Alicia M. Zha; Italo Linfante; Ameer E Hassan; Darko Quispe-Orozco; Santiago Ortega-G...; Priyank Khandelwal; Pratit Patel; Osama Zaidat; Tudor G. Jovin; Scott Kamen; James E. Siegler
• Keywords: Neuroradiology; Stroke; Pandemic; Odds

We have demonstrated in a multicenter cohort that the COVID-19 pandemic has led to delay intravenous thrombolysis (IVT) among stroke patients. Whether this contributes meaningful short-term outcome differences these patients warranted further exploration. conducted nested observational study of adult acute ischemic receiving IVT from 9 comprehensive centers across 7 U.S states. Patients admitted prior (1/1/2019–02/29/2020) were compared during early (3/1/2020–7/31/2020). Multivariable logistic regression was used estimate effect on discharge hospice or death, with treatment admission included as an interaction term. Of 676 thrombolysed patients, median age 70 (IQR 58–81) years, 313 female (46.3%), and NIHSS 8 4–16). Longer delays observed (median 46 vs 38 min, p = 0.01) associated higher in-hospital death/hospice irrespective period (OR per hour 1.08, 95% CI 1.01–1.17, 0.03). This strengthened after multivariable adjustment (aOR 1.15, 1.07–1.24, < 0.001). There no (pinteraction 0.65). Every one-hour also 7% lower odds being discharged home inpatient rehabilitation facility 0.93, 0.89–0.97, Treatment greater mortality care, probability home/rehabilitation facility. modification pandemic, indicating at any time similarly outcomes.