Acute stroke treatment during COVID-19 pandemic "lockdown" period - Croatian experience

Background and purpose: Inevitable lockdown scenario during the first wave of COVID-19 pandemic led to different approaches of medical care system worldwide. During this period, health care services faced the problem of time, place and human resources management. However, in spite of redirecting health forces to fight this new and unknown virus in all countries, the need of routine treatment of all the other emergencies according to the guidelines remained present. The aim of our study was to analyse the acute stroke care in Croatia during first wave of Covid pandemic. Materials and methods: In order to achieve the rate of stroke patients admitted to hospital care in dedicated hospital stroke units and centers, we have gathered the data from four Croatian University Hospitals. We analyzed the number of hospitalized stroke patients from 1th of February to 1th of May 2020 and the proportions of patients treated with recanalization therapy. Results: Our results showed a slight decrease of number of all neurological patients who arrived to the Emergency Unit. In 2019 recanalization therapy was given to 158 patients (19%) vs 177 (26%) in 2020. Thrombolysis alone was given to 72 (9%) of patients in 2019 and to 68 (10%) of patients in 2020, while thrombectomy (with or without thrombolysis) has been performed to 86 (10%) vs 109 (16%) patients in 2019 and 2020 respectively. Conclusion: In conclusion, we did not notice less severe stroke patients or lower level of stroke care in University Hospitals.