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  • Intravenous thrombolysis for acute ischaemic stroke during COVID‐19 pandemic in Wuhan, China: a multicentre, retrospective cohort study

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Intravenous thrombolysis for acute ischaemic stroke during COVID‐19 pandemic in Wuhan, China: a multicentre, retrospective cohort study
  1. Yifan Zhou1,
  2. Candong Hong1,
  3. Jiang Chang2,
  4. Yuanpeng Xia1,
  5. Huijuan Jin1,
  6. Yanan Li1,
  7. Ling Mao1,
  8. Yong Wang1,
  9. Lei Zhang1,
  10. Chunlian Pan3,
  11. Jichuan Hu4,
  12. Ming Huang5,
  13. David Wang6,
  14. Shengcai Chen1,
  15. Bo Hu1
  1. 1 Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
  2. 2 Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
  3. 3 Department of Neurology, Puren Hospitol Affiliated to Wuhan University of Science and Technolog, Wuhan 430081, China
  4. 4 Department of Neurology, People's Hospital of Dongxihu District, Wuhan 430040, China
  5. 5 Department of Neurology, the People’s Hospital of China Three Gorges University, Institute of Translational Neuroscience, Three Gorges University College of Medical Science, Yichang 443002, China
  6. 6 Neurovascular Division, Department of Neurology, Barrow Neurological Institute/Saint Joseph Hospital Medical Center, Phoenix, AZ85013, USA
  1. Correspondence to Professor Bo Hu, Department of Neurology, Union Hospital, Huazhong University of Science and Technology Tongji Medical College, Wuhan, Hubei, China; hubo{at}mail.hust.edu.cn; Dr Shengcai Chen; chenshengcai2006{at}126.com; Professor David Wang; dwang{at}uic.edu

https://doi.org/10.1136/jnnp-2020-324014

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    Introduction

    COVID-19 has become a global pandemic. The rapid outbreak has overwhelmed healthcare system and exhausted medical resources. There is a concern that many patients with other diseases cannot be promptly treated.

    Stroke is the leading cause of death and disability worldwide. In the context of COVID-19 epidemic, stroke remains to be a medical emergency. Ultraearly intravenous thrombolysis for patients with acute ischaemic stroke (AIS) is highly time-sensitive.1 How to balance the benefit of timely and efficacious care of the stroke patients to the risk of SARS-CoV-2 infection of healthcare professionals is the most challenging issue. Recently, there have been reports on the decreasing the Reporting of Observational Studies in Epide of cases of patients with stroke presented to the hospitals during the pandemic.2 On the other hand, stroke is not uncommon among patients with COVID-19.3 Here, we report intravenous thrombolytic therapy for patients with AIS at four stroke centres in the epicentre of Wuhan, Hubei during the epidemic, and compare the treatment provided during the same period in 2019.

    Methods

    Study design

    This is a retrospective analysis of two groups of patients with AIS received intravenous tissue plasminogen activator (tPA) during 1 January to 30 Marchh of 2019 and 2020 in four hospitals (Wuhan Union Hospital,Wuhan Puren Hospitol, Wuhan People’s Hospital of Dongxihu District, People’s Hospital of Three Gorges University in Yichang adjacent to Wuhan). All four hospitals continuously received emergency cases during COVID-19 epidemic. The deadline for follow-up was 30 April 2020.

    Participants

    All patients with AIS enrolled must meet the following criteria: (1) treated with intravenous tPA (0.9 mg/kg), (2) received either a CT or MRI of brain before/after intravenous tPA. All patients with AIS treated with intravenous tPA had real-time reverse-transcription PCR analysis (RT-PCR) from the throat swab specimens and a chest CT scan during hospitalisation and follow-up …

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    Footnotes

    • YZ, CH and JC contributed equally.

    • Contributors BH was responsible for the concept and design of the study. YZ did the literature search. YZ, SC and CH acquired and interpreted data. JC analyzed the data. YZ, CH and SC wrote the manuscript. DW revised the the manuscript. HJ, YL, YX, LM, YW and LZ did the administrative, technical, or material support. CP, JH and MH did the material support.

    • Funding This work was supported by the National Key Research and Development Program of China (No. 2018YFC1312200 to BH), the National Natural Science Foundation of China (No. 81820108010 to BH, NO. 81901212 to YFZ, NO. 81801172 to SCC), the Natural Science Foundation of Hubei Health Committee of China (No. WJ2019Q017 to MH).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The study was performed in accordance to the principles of the Declaration of Helsinki and was approved by the Research Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Number/ID：(2020)(0068).

    • Provenance and peer review Not commissioned; externally peer reviewed.