The Effects of the Coronavirus Disease Pandemicon Intravenous Thrombolytic Therapy in Patients with Acute Ischemic Stroke in Dalian, China

Objective: We investigated the influence of the coronavirus disease (COVID-19) pandemic on the number of patients with acute ischemic stroke who received intravenous thrombolytic therapy (ITT) in Dalian, China, in 2020. Methods: : This retrospective descriptive study examined 13 stroke emergency map-participating hospitals in Dalian from February 1, 2020, to August 31, 2020. In this “stroke emergency map” of China, patients follow the official WeChat “Stroke Map” account and dial 120 for emergency medical services. We analyzed the number of patients with acute ischemic stroke who underwent ITT. In particular, we examined the onset-to-door time, door-to-needle time (DNT), onset-to-needle time, modes of transportation to the hospital, and National Institutes of Health Stroke Scale (NIHSS) scores before and after ITT. Data were collected for the aforementioned period and compared with the 2021 baseline data from the same period. The Mann‒Whitney U test was performed for data analysis. Results: : Compared with the data from 2020, the number of patients with acute ischemic stroke who underwent ITT increased (from 739 to 1719 cases) in 2021, as did the DNT (from 59 to 45 minutes; P=0.002). Moreover, 83.9% of patients presented to the hospital without ambulance transport versus 81.1% of patients in the 2021 non-COVID-19 pandemic period. Patients with NIHSS scores of 6-14 were more likely to call an ambulance for transport to the hospital than to self-admit to the emergency department. Conclusions: : During the 2020 COVID-19 pandemic, the DNT increased owing to increased surveillance of fever. Furthermore, the number of patients with acute ischemic stroke who underwent ITT also increased in 2021. However, these increases benefited from both the “stroke emergency map” of China and the “green channel,” a novel treatment approach that focuses on the rational design of the rescue process.