Maintaining stroke care in Europe during the COVID-19 pandemic: Results from an international survey of stroke professionals and practice recommendations from the European Stroke Organisation

This represents everything that is wrong in stroke. 'Care' NOT RESULTS OR RECOVERY. Tyranny of low expectations here

Maintaining stroke care in Europe during the COVID-19 pandemic: Results from an international survey of stroke professionals and practice recommendations from the European Stroke Organisation 

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Diana Aguiar de Sousa, H Bart van der Worp, Valeria Caso, ...

First Published June 10, 2020 Research Article

https://doi.org/10.1177/2396987320933746

Article information

Abstract

Introduction

The coronavirus disease 2019 (COVID-19) pandemic has been placing an overwhelming burden on health systems, thus threatening their ability to operate effectively for acute conditions in which treatments are highly time sensitive, such as cerebrovascular disorders and myocardial infarction. As part of an effort to reduce the consequences of this outbreak on health service delivery to stroke patients, the European Stroke Organisation has undertaken a survey aimed at collecting information on the provision of stroke care during the pandemic.

Methods

Cross-sectional, web-based survey, conducted from 26 March through 1 April 2020 among stroke care providers, focused on reorganisation of health services, the delivery of acute and post-acute stroke care and the availability of personal protective equipment.

Results

A total of 426 stroke care providers from 55 countries completed the survey, most of whom worked in Europe (n = 375, 88%) and were stroke physicians/neurologists (n = 334, 78%). Among European respondents, 289 (77%) reported that not all stroke patients were receiving the usual care in their centres and 266 (71%) estimated that functional outcomes and recurrence rates of stroke patients would be negatively affected by the organisational changes caused by the pandemic. The areas considered as being most affected were acute care and rehabilitation. Most professionals had to adapt their activities and schedules and more than half reported shortage of protective equipment.

Discussion

Strategies to maintain availability of stroke care during the COVID-19 outbreak are crucial to prevent indirect mortality and disability due to suboptimal care.

Conclusion

European Stroke Organisation proposes a set of targeted actions for decision makers facing this exceptional situation.

Keywords Stroke, health services, COVID-19, stroke care

Background and objectives

The coronavirus disease 2019 (COVID-19)¹ outbreak has been spreading rapidly around the world and places an overwhelming burden on emergency systems, health-care facilities and health-care workers. Also, governmental instructions together with the response pattern of the population, due to fear of infection in medical facilities, have led to a situation where several elective consultations and procedures have been postponed. Resource restrictions for urgent health conditions, such as stroke and myocardial infarction, may have a significant impact on mortality and morbidity, potentially even larger than that of COVID-19 disease itself. An increase in mortality associated with treatable conditions has been demonstrated during previous viral outbreaks such as the 2009 influenza A H1N1 virus, in which a greater surge in hospital admissions was associated with significant increases in the mortality attributable to other diseases, including stroke and acute myocardial infarction.^2,3
Currently, data are not available regarding the impact of the pandemic on access to and delivery of stroke care in Europe. As part of the ongoing effort to reduce the consequences of COVID-19 on health service delivery to stroke patients, the European Stroke Organisation (ESO) has undertaken a survey aimed at collecting information on the current provision of stroke care. These results should provide relevant information to direct activities aimed at promoting the best possible care to all stroke patients during the pandemic and support stroke physicians and other professionals working in the field.