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November 19, 2020

SVIN Task Force Evaluates Paradigm Shifts in Medical Care During COVID-19 Pandemic

November 19, 2020—The Society of Vascular and Interventional Neurology (SVIN) announced the release of a study by James Siegler, MD, and SVIN investigators that identifies the significant changes in medical care caused by the COVID-19 pandemic, from triage to treatment. The study, “Paradigm Shifts in Medical Care During COVID-19 Pandemic,” was presented by the SVIN COVID-19 Registry & Task Force at the SVIN annual meeting held virtually November 18-21.

According to SVIN, the study investigators used a novel lens to explore the indirect consequences of the COVID-19 pandemic. The background of the study is that many reports have indicated that patients are avoiding health care institutions to prevent contact with COVID-19 patients and health care professionals. Falling rates have been observed across a range of acute and critical conditions, including myocardial infarction, stroke, and various cancers. The long-term consequences of health care avoidance remain unknown but will become clear in the coming months and years, noted SVIN.

As summarized in the SVIN announcement, the United States multicenter observational study evaluated the timeline of critical care provided to patients with acute ischemic stroke. The investigators pooled prospectively maintained data from 14 comprehensive stroke centers in nine states between January 2019 and July 2020. These nine states account for approximately half of all COVID-19 cases in the United States and more than one-third of all COVID-19–associated mortalities. If any indirect effect of the pandemic were to influence the care of stroke patients, it would involve these high-risk geographical regions, noted SVIN.

The objective of this investigation was to determine if patients were receiving standard-of-care reperfusion therapies (eg, intravenous thrombolysis and/or thrombectomy) with the same expediency during the COVID-19 period as they were in the months before the pandemic.

Using the American Heart Association/American Stroke Association Target: Stroke campaign’s goal of a 60-minute door-to-needle time for intravenous thrombolysis as a primary outcome, it was found that patients admitted to these hospitals during the COVID-19 pandemic had 45% lower odds of being treated in that 60-minute time window (adjusted odds ratio, 0.55; 95% CI, 0.35-0.85), reported the SVIN Task Force.

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