Evidence map›Paper›PMID 32438895›Full record

ArticleStroke2020

Acute Stroke Care Is at Risk in the Era of COVID-19: Experience at a Comprehensive Stroke Center in Barcelona.

Salvatore Rudilosso, Carlos Laredo, Víctor Vera, Martha Vargas, Arturo Renú, Laura Llull, Víctor Obach, Sergio Amaro, Xabier Urra, Ferrán Torres and 2 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 144 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
144citing papers in PubMed, 7 pooled it
31.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

144 citing papers in PubMed, 7 syntheses or guidelines pooled it, 240 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Stroke network performance during the first COVID-19 pandemic stage: A meta-analysis based on stroke network models.International journal of stroke : official journal of the International Stroke Society · 2021
    Pooled it
  4. Pooled it
  5. Impact of the Coronavirus Disease Pandemic on the Number of Strokes and Mechanical Thrombectomies: A Systematic Review and Meta-Analysis.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2020
    Pooled it
  6. Current Recommendations for the Management of Stroke Patients in the Middle East in the Era of COVID-19 Pandemic; Statement from the MENA SINO.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2020
    Guideline
  7. Pooled it
  8. Article
  9. Article
  10. Article
  11. Observational
  12. Article
  13. Article
  14. COVID-19 and stroke in women: impact on clinical, psychosocial and research aspects.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024
    Review
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  16. Article
  17. Observational
  18. Observational
  19. Article
  20. Observational

84 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 1 country.

Salvatore Rudilosso *Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.).
Carlos Laredo *Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.).
Víctor VeraComprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.).
Martha VargasComprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.).
Arturo RenúComprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.).
Laura LlullComprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.).
Víctor ObachComprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.).
Sergio AmaroComprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.).
Xabier UrraComprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.).
Ferrán TorresBiostatistics Unit, Autonomous University of Barcelona, Spain (F.T.).
Francesc Xavier Jiménez-FàbregaSistema d'Emergències Mèdiques, Barcelona, Spain (F.X.J.-F.).
Ángel ChamorroComprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.).
Consorci Institut D'Investigacions Biomediques August Pi I Sunyer · ESFundació Privada Clínic per a La Recerca Biomèdica · ESHospital Clínic de Barcelona · ESUniversitat Autònoma de Barcelona · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeThe purpose of the study is to analyze how the coronavirus disease 2019 (COVID-19) pandemic affected acute stroke care in a Comprehensive Stroke Center.

methodsOn February 28, 2020, contingency plans were implemented at Hospital Clinic of Barcelona to contain the COVID-19 pandemic. Among them, the decision to refrain from reallocating the Stroke Team and Stroke Unit to the care of patients with COVID-19. From March 1 to March 31, 2020, we measured the number of emergency calls to the Emergency Medical System in Catalonia (7.5 million inhabitants), and the Stroke Codes dispatched to Hospital Clinic of Barcelona. We recorded all stroke admissions, and the adequacy of acute care measures, including the number of thrombectomies, workflow metrics, angiographic results, and clinical outcomes. Data were compared with March 2019 using parametric or nonparametric methods as appropriate.

resultsAt Hospital Clinic of Barcelona, 1232 patients with COVID-19 were admitted in March 2020, demanding 60% of the hospital bed capacity. Relative to March 2019, the Emergency Medical System had a 330% mean increment in the number of calls (158 005 versus 679 569), but fewer Stroke Code activations (517 versus 426). Stroke admissions (108 versus 83) and the number of thrombectomies (21 versus 16) declined at Hospital Clinic of Barcelona, particularly after lockdown of the population. Younger age was found in stroke admissions during the pandemic (median [interquartile range] 69 [64-73] versus 75 [73-80] years,

conclusionsThe COVID-19 pandemic reduced by a quarter the stroke admissions and thrombectomies performed at a Comprehensive Stroke Center but did not affect the quality of care metrics. During the lockdown, there was an overload of emergency calls but fewer Stroke Code activations, particularly in elderly patients. Hospital contingency plans, patient transport systems, and population-targeted alerts must act concertedly to better protect the chain of stroke care in times of pandemic.

Indexed as

BetacoronavirusCoronavirus InfectionsPandemicsPneumonia, ViralAcute DiseaseAge DistributionCOVID-19Emergency Medical ServicesEmergency Service, HospitalHospital Bed CapacityHospitals, SpecialHospitals, UrbanHumansIntensive Care UnitsNeuroimagingPatient Acceptance of Health CareCOVID-19pandemicSpainthrombectomyworkflow

Identifiers

PMID32438895
PMCPMC7258755
OpenAlexW3028459133

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.