Impact of SARS-CoV-2 (COVID-19) pandemic on acute stroke care in Latvia

In 2018 Pauls Stradins Clinical University hospital (PSCUH) joined a quality improvement initiative (Angels Initiative). We have achieved good results in optimizing the quality of treatment of patients diagnosed with acute ischemic stroke (AIS). The World Health Organization declared the outbreak of COVID-19 in January 2020 and a pandemic in March 2020. In Latvia, the first case of COVID-2019 was diagnosed on March 2, 2020, and the number of cases is still growing. Despite the measures, which were taken we observe changes in quality of treatment of patients diagnosed with AIS. Our aim of this study was to evaluate recanalization therapy for AIS patients done in PSCUH during of COVID-19 pandemic. We included patients discharged from PSCUH with diagnosis of AIS in 2019 and 2020. We collected the data about recanalization therapy and what was the door-needle time. We compared the results between each quarter (Q1–Q4) in 2019 and 2020. 2019: Q1- 219 patients admitted, recanalization rate 33,59%, average door-needle time- 35 min Q2- 260 patients admitted, recanalization rate 31,47%, average door-needle time- 40 min Q3- 291 patients admitted, recanalization rate 36,47%, average door-needle time- 35 min Q4- 300 patients admitted, recanalization rate 32,02%, average door-needle time- 28 min 2020: Q1- 328 patients admitted, recanalization rate 35,35%, average door-needle time- 20 min Q2- 222 patients admitted, recanalization rate 31,37%, average door-needle time- 41,5 min Q3- 233 patients admitted, recanalization rate 32,08%, average door-needle time- 20 min Q4- 180 patients admitted, recanalization rate 37,5%, average door-needle time- 20 min The most impact was seen in Q2 of 2020, that is the start of the COVID-19 pandemic. Showing reduced recanalization rates and longer door-to-needle time. The results improved as the pandemic wore on. We observed less patients admitted during the time of pandemic.