SynthesisInternational journal of stroke : official journal of the International Stroke Society2021
Stroke network performance during the first COVID-19 pandemic stage: A meta-analysis based on stroke network models.
Synthesis in International journal of stroke : official journal of the International Stroke Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Trends and disparities in NIHSS reporting and outcomes in acute ischemic stroke hospitalizations: A retrospective cross-sectional study.Acta neurochirurgica · 2026Article
- Global Burden of Ischemic Heart Disease and Ischemic Stroke, 1990-2023: Spatial Heterogeneity, SDI Inequalities, Pandemic-Era Inflections, and Scenario Forecasts to 2035 Using GBD 2023.Cardiology research and practice · 2026Article
- Stroke care in the United Kingdom before, during, and after the COVID-19 lockdowns: A retrospective nationwide cohort study.PloS one · 2025Article
- A command centre implementation before and during the COVID-19 pandemic in a community hospital.BMC medical informatics and decision making · 2024Article
- Article
- Stroke Care Pathway ensures high-quality stroke management in the COVID-19 pandemic.Scientific reports · 2023Article
- Global Impact of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events: A 1-Year Follow-up.Neurology · 2023Observational
- Drip-and-ship toward mothership model for mechanical thrombectomy during COVID-19 pandemic: a retrospective analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2023Article
- Comprehensive Geriatric Hospital at Home: Adaptation to Referral and Case-Mix Changes During the COVID-19 Pandemic.Journal of the American Medical Directors Association · 2023Observational
- Cerebro-/Cardiovascular Collateral Damage During the COVID-19 Pandemic: Fact or Fiction?Journal of clinical neurology (Seoul, Korea) · 2023Review
- Stroke admissions during the COVID-19 pandemic: a single-center retrospective analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022Article
- Intravenous Thrombolysis for Acute Ischemic Stroke during the COVID-19 Pandemic-Polish Single-Center Retrospective Cohort Study.Life (Basel, Switzerland) · 2022Article
- Delirium on stroke units: a prospective, multicentric quality-improvement project.Journal of neurology · 2022Article
- Stroke in the COVID-19 pandemic era.Postepy psychiatrii neurologii · 2022Review
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20 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe effect of the COVID pandemic on stroke network performance is unclear, particularly with consideration of drip&ship vs. mothership models.
aimsWe systematically reviewed and meta-analyzed variations in stroke admissions, rate and timing of reperfusion treatments during the first wave COVID pandemic vs. the pre-pandemic timeframe depending on stroke network model adopted. SUMMARY OF
findingsThe systematic review followed registered protocol (PROSPERO-CRD42020211535), PRISMA and MOOSE guidelines. We searched MEDLINE, EMBASE, and CENTRAL until 9 October 2020 for studies reporting variations in ischemic stroke admissions, treatment rates, and timing in COVID (first wave) vs. control-period. Primary outcome was the weekly admission incidence rate ratio (IRR = admissions during COVID-period/admissions during control-period). Secondary outcomes were (i) changes in rate of reperfusion treatments and (ii) time metrics for pre- and in-hospital phase. Data were pooled using random-effects models, comparing mothership vs. drip&ship model. Overall, 29 studies were included in quantitative synthesis (n = 212,960). COVID-period was associated with a significant reduction in stroke admission rates (IRR = 0.69, 95%CI = 0.61-0.79), with higher relative presentation of large vessel occlusion (risk ratio (RR) = 1.62, 95% confidence interval (CI) = 1.24-2.12). Proportions of patients treated with endovascular treatment increased (RR = 1.14, 95%CI = 1.02-1.28). Intravenous thrombolysis decreased overall (IRR = 0.72, 95%CI = 0.54-0.96) but not in the mothership model (IRR = 0.81, 95%CI = 0.43-1.52). Onset-to-door time was longer for the drip&ship in COVID-period compared to the control-period (+32 min, 95%CI = 0-64). Door-to-scan was longer in COVID-period (+5 min, 95%CI = 2-7). Door-to-needle and door-to-groin were similar in COVID-period and control-period.
conclusionsDespite a 35% drop in stroke admissions during the first pandemic wave, proportions of patients receiving reperfusion and time-metrics were not inferior to control-period. Mothership preserved the weekly rate of intravenous thrombolysis and the onset-to-door timing to pre-pandemic standards.
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