Stroke care during the COVID-19 pandemic: experience from three large European countries.
Identifieur interne : 000E62 ( Main/Exploration ); précédent : 000E61; suivant : 000E63Stroke care during the COVID-19 pandemic: experience from three large European countries.
Auteurs : A. Bersano [Italie] ; M. Kraemer [Allemagne] ; E. Touzé [France] ; R. Weber [Allemagne] ; S. Alamowitch [France] ; I. Sibon [France] ; L. Pantoni [Italie]Source :
- European journal of neurology [ 1468-1331 ] ; 2020.
Descripteurs français
- KwdFr :
- MESH :
- diagnostic : Accident vasculaire cérébral.
- mortalité : Accident vasculaire cérébral.
- thérapie : Accident vasculaire cérébral.
- Allemagne, Europe, France, Humains, Hôpitaux, Italie, Pandémies.
- Wicri :
English descriptors
- KwdEn :
- MESH :
Abstract
In order to cope with the exponentially increasing number of patients infected with SARS-CoV-2, European countries made enormous efforts to reorganize medical assistance and several diseases, including stroke, were particularly impacted. We report the experience of stroke neurologists from three European countries (Italy, France and Germany) that faced the pandemic at diverse time points and with different approaches, depending on their resources and healthcare system organization. Pre-hospital and in-hospital acute stroke pathways were reorganized to prioritize COVID-19 management and, in severely affected regions of Italy and France, stroke care was centralized to a limited number of centers, whereas the remaining stroke units were dedicated to patients with COVID-19. Access to acute stroke diagnostics and time-dependent therapies was limited or delayed because of reduced capacities of emergency services due to the burden of patients with COVID-19. A marked reduction in the number of patients presenting with transient ischaemic attack and stroke was noted in the emergency departments of all three countries. Although we only have preliminary data, these conditions may have affected stroke outcome. These indirect effects of the COVID-19 pandemic could negate the efforts of stroke neurologists over the last few years to improve outcome and reduce mortality of stroke patients. Although the SARS-CoV-2 infection rate is slowing down in Europe, the effects of ending lockdown in the next months are unpredictable. It is important for the European and world stroke community to share what has been learned so far to be plan strategies to ensure stroke care in the future and upcoming challenging times.
DOI: 10.1111/ene.14375
PubMed: 32492764
PubMed Central: PMC7300856
Affiliations:
- Allemagne, France, Italie
- Aquitaine, Basse-Normandie, Lombardie, Nouvelle-Aquitaine, Région Normandie, Île-de-France
- Bordeaux, Milan, Paris
Links toward previous steps (curation, corpus...)
Le document en format XML
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Bersano</name><affiliation wicri:level="3"><nlm:affiliation>Cerebrovascular Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Cerebrovascular Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Kraemer, M" sort="Kraemer, M" uniqKey="Kraemer M" first="M" last="Kraemer">M. 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Weber</name><affiliation><nlm:affiliation>Department of Neurology, Alfried Krupp Krankenhaus Essen, Essen.</nlm:affiliation><wicri:noCountry code="subField">Essen</wicri:noCountry></affiliation><affiliation wicri:level="1"><nlm:affiliation>Faculty of Medicine, Ruhr-University Bochum, Bochum, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Faculty of Medicine, Ruhr-University Bochum, Bochum</wicri:regionArea><wicri:noRegion>Bochum</wicri:noRegion><wicri:noRegion>Bochum</wicri:noRegion><wicri:noRegion>Bochum</wicri:noRegion></affiliation></author><author><name sortKey="Alamowitch, S" sort="Alamowitch, S" uniqKey="Alamowitch S" first="S" last="Alamowitch">S. Alamowitch</name><affiliation wicri:level="3"><nlm:affiliation>Department of Neurology, Inserm, UMRS 938, Hôpital St-Antoine, AP-HP, Sorbonne Université, Paris.</nlm:affiliation><country>France</country><placeName><settlement type="city">Paris</settlement><region type="région" nuts="2">Île-de-France</region></placeName><wicri:orgArea>Department of Neurology, Inserm, UMRS 938, Hôpital St-Antoine, AP-HP, Sorbonne Université</wicri:orgArea></affiliation></author><author><name sortKey="Sibon, I" sort="Sibon, I" uniqKey="Sibon I" first="I" last="Sibon">I. Sibon</name><affiliation wicri:level="3"><nlm:affiliation>Stroke Unit, Department of Neurology, CHU Bordeaux, Bordeaux University, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Stroke Unit, Department of Neurology, CHU Bordeaux, Bordeaux University, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Pantoni, L" sort="Pantoni, L" uniqKey="Pantoni L" first="L" last="Pantoni">L. Pantoni</name><affiliation wicri:level="3"><nlm:affiliation>Stroke and Dementia Laboratory, 'Luigi Sacco' Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Stroke and Dementia Laboratory, 'Luigi Sacco' Department of Biomedical and Clinical Sciences, University of Milan, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author></analytic><series><title level="j">European journal of neurology</title><idno type="eISSN">1468-1331</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>COVID-19 (MeSH)</term><term>Europe (MeSH)</term><term>France (MeSH)</term><term>Germany (MeSH)</term><term>Hospitals (MeSH)</term><term>Humans (MeSH)</term><term>Italy (MeSH)</term><term>Pandemics (MeSH)</term><term>Stroke (diagnosis)</term><term>Stroke (mortality)</term><term>Stroke (therapy)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Accident vasculaire cérébral (diagnostic)</term><term>Accident vasculaire cérébral (mortalité)</term><term>Accident vasculaire cérébral (thérapie)</term><term>Allemagne (MeSH)</term><term>Europe (MeSH)</term><term>France (MeSH)</term><term>Humains (MeSH)</term><term>Hôpitaux (MeSH)</term><term>Italie (MeSH)</term><term>Pandémies (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Europe</term><term>France</term><term>Germany</term><term>Italy</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Stroke</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Accident vasculaire cérébral</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Stroke</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Accident vasculaire cérébral</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Stroke</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Accident vasculaire cérébral</term></keywords><keywords scheme="MESH" xml:lang="en"><term>COVID-19</term><term>Hospitals</term><term>Humans</term><term>Pandemics</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Allemagne</term><term>Europe</term><term>France</term><term>Humains</term><term>Hôpitaux</term><term>Italie</term><term>Pandémies</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>France</term><term>Allemagne</term><term>Italie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In order to cope with the exponentially increasing number of patients infected with SARS-CoV-2, European countries made enormous efforts to reorganize medical assistance and several diseases, including stroke, were particularly impacted. We report the experience of stroke neurologists from three European countries (Italy, France and Germany) that faced the pandemic at diverse time points and with different approaches, depending on their resources and healthcare system organization. Pre-hospital and in-hospital acute stroke pathways were reorganized to prioritize COVID-19 management and, in severely affected regions of Italy and France, stroke care was centralized to a limited number of centers, whereas the remaining stroke units were dedicated to patients with COVID-19. Access to acute stroke diagnostics and time-dependent therapies was limited or delayed because of reduced capacities of emergency services due to the burden of patients with COVID-19. A marked reduction in the number of patients presenting with transient ischaemic attack and stroke was noted in the emergency departments of all three countries. Although we only have preliminary data, these conditions may have affected stroke outcome. These indirect effects of the COVID-19 pandemic could negate the efforts of stroke neurologists over the last few years to improve outcome and reduce mortality of stroke patients. Although the SARS-CoV-2 infection rate is slowing down in Europe, the effects of ending lockdown in the next months are unpredictable. It is important for the European and world stroke community to share what has been learned so far to be plan strategies to ensure stroke care in the future and upcoming challenging times.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">32492764</PMID><DateCompleted><Year>2020</Year><Month>12</Month><Day>17</Day></DateCompleted><DateRevised><Year>2020</Year><Month>12</Month><Day>17</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1468-1331</ISSN><JournalIssue CitedMedium="Internet"><Volume>27</Volume><Issue>9</Issue><PubDate><Year>2020</Year><Month>09</Month></PubDate></JournalIssue><Title>European journal of neurology</Title><ISOAbbreviation>Eur J Neurol</ISOAbbreviation></Journal><ArticleTitle>Stroke care during the COVID-19 pandemic: experience from three large European countries.</ArticleTitle><Pagination><MedlinePgn>1794-1800</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1111/ene.14375</ELocationID><Abstract><AbstractText>In order to cope with the exponentially increasing number of patients infected with SARS-CoV-2, European countries made enormous efforts to reorganize medical assistance and several diseases, including stroke, were particularly impacted. We report the experience of stroke neurologists from three European countries (Italy, France and Germany) that faced the pandemic at diverse time points and with different approaches, depending on their resources and healthcare system organization. Pre-hospital and in-hospital acute stroke pathways were reorganized to prioritize COVID-19 management and, in severely affected regions of Italy and France, stroke care was centralized to a limited number of centers, whereas the remaining stroke units were dedicated to patients with COVID-19. Access to acute stroke diagnostics and time-dependent therapies was limited or delayed because of reduced capacities of emergency services due to the burden of patients with COVID-19. A marked reduction in the number of patients presenting with transient ischaemic attack and stroke was noted in the emergency departments of all three countries. Although we only have preliminary data, these conditions may have affected stroke outcome. These indirect effects of the COVID-19 pandemic could negate the efforts of stroke neurologists over the last few years to improve outcome and reduce mortality of stroke patients. Although the SARS-CoV-2 infection rate is slowing down in Europe, the effects of ending lockdown in the next months are unpredictable. It is important for the European and world stroke community to share what has been learned so far to be plan strategies to ensure stroke care in the future and upcoming challenging times.</AbstractText><CopyrightInformation>© 2020 European Academy of Neurology.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Bersano</LastName><ForeName>A</ForeName><Initials>A</Initials><Identifier Source="ORCID">0000-0002-2493-628X</Identifier><AffiliationInfo><Affiliation>Cerebrovascular Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kraemer</LastName><ForeName>M</ForeName><Initials>M</Initials><Identifier Source="ORCID">0000-0002-5667-3621</Identifier><AffiliationInfo><Affiliation>Department of Neurology, Alfried Krupp Krankenhaus Essen, Essen.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>University Clinic of Duesseldorf, Heinrich Heine University, Duesseldorf, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Touzé</LastName><ForeName>E</ForeName><Initials>E</Initials><Identifier Source="ORCID">0000-0002-7254-2162</Identifier><AffiliationInfo><Affiliation>Université Caen Normandie, Inserm U1237, CHU Caen Normandie, Service de Neurologie, GIP Cyceron, Caen, 14000, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Weber</LastName><ForeName>R</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Neurology, Alfried Krupp Krankenhaus Essen, Essen.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Faculty of Medicine, Ruhr-University Bochum, Bochum, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Alamowitch</LastName><ForeName>S</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Neurology, Inserm, UMRS 938, Hôpital St-Antoine, AP-HP, Sorbonne Université, Paris.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sibon</LastName><ForeName>I</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Stroke Unit, Department of Neurology, CHU Bordeaux, Bordeaux University, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pantoni</LastName><ForeName>L</ForeName><Initials>L</Initials><Identifier Source="ORCID">0000-0001-7357-8530</Identifier><AffiliationInfo><Affiliation>Stroke and Dementia Laboratory, 'Luigi Sacco' Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016448">Multicenter Study</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>06</Month><Day>27</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Eur J Neurol</MedlineTA><NlmUniqueID>9506311</NlmUniqueID><ISSNLinking>1351-5101</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Eur J Neurol. 2020 Sep;27(9):1793</RefSource><PMID Version="1">32548937</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="Y">COVID-19</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005060" MajorTopicYN="N" Type="Geographic">Europe</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005602" MajorTopicYN="N" Type="Geographic">France</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005858" MajorTopicYN="N" Type="Geographic">Germany</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006761" MajorTopicYN="N">Hospitals</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007558" MajorTopicYN="N" Type="Geographic">Italy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="Y">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020521" MajorTopicYN="N">Stroke</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">COVID-19</Keyword><Keyword MajorTopicYN="Y">Europe</Keyword><Keyword MajorTopicYN="Y">care</Keyword><Keyword MajorTopicYN="Y">emergency</Keyword><Keyword MajorTopicYN="Y">outbreak</Keyword><Keyword MajorTopicYN="Y">pathways</Keyword><Keyword MajorTopicYN="Y">stroke</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>04</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>05</Month><Day>24</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>6</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>12</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>6</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32492764</ArticleId><ArticleId IdType="doi">10.1111/ene.14375</ArticleId><ArticleId IdType="pmc">PMC7300856</ArticleId></ArticleIdList><ReferenceList><Title>References</Title><Reference><Citation>COVID-19 information and resources 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Weber</name></country><country name="France"><region name="Région Normandie"><name sortKey="Touze, E" sort="Touze, E" uniqKey="Touze E" first="E" last="Touzé">E. Touzé</name></region><name sortKey="Alamowitch, S" sort="Alamowitch, S" uniqKey="Alamowitch S" first="S" last="Alamowitch">S. Alamowitch</name><name sortKey="Sibon, I" sort="Sibon, I" uniqKey="Sibon I" first="I" last="Sibon">I. Sibon</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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