Impact of SARS-CoV-2 on reperfusion therapies for acute ischemic stroke in Lombardy, Italy: the STROKOVID network

Alessandro Pezzini, Mario Grassi, Giorgio Silvestrelli, Martina Locatelli, Nicola Rifino, Simone Beretta, Massimo Gamba, Elisa Raimondi, Giuditta Giussani, Federico Carimati, Davide Sangalli, Manuel Corato, Simonetta Gerevini, Stefano Masciocchi, Matteo Cortinovis, Sara La Gioia, Francesca Barbieri, Valentina Mazzoleni, Debora Pezzini, Sonia BonacinaAndrea Pilotto, Alberto Benussi, Mauro Magoni, Enrico Premi, Alessandro Cesare Prelle, Elio Clemente Agostoni, Fernando Palluzzi, Valeria De Giuli, Anna Magherini, Daria Valeria Roccatagliata, Luisa Vinciguerra, Valentina Puglisi, Laura Fusi, Rubjona Xhani, Federico Pozzi, Susanna Diamanti, Francesco Santangelo, Giampiero Grampa, Maurizio Versino, Andrea Salmaggi, Simona Marcheselli, Anna Cavallini, Alessia Giossi, Bruno Censori, Carlo Ferrarese, Alfonso Ciccone, Maria Sessa, Alessandro Padovani

Research output: Contribution to journalArticlepeer-review


Whether and how SARS-CoV-2 outbreak affected in-hospital acute stroke care system is still matter of debate. In the setting of the STROKOVID network, a collaborative project between the ten centers designed as hubs for the treatment of acute stroke during SARS-CoV-2 outbreak in Lombardy, Italy, we retrospectively compared clinical features and process measures of patients with confirmed infection (COVID-19) and non-infected patients (non-COVID-19) who underwent reperfusion therapies for acute ischemic stroke. Between March 8 and April 30, 2020, 296 consecutive patients [median age, 74 years (interquartile range (IQR), 62-80.75); males, 154 (52.0%); 34 (11.5%) COVID-19] qualified for the analysis. Time from symptoms onset to treatment was longer in the COVID-19 group [230 (IQR 200.5-270) minutes vs. 190 (IQR 150-245) minutes; p = 0.007], especially in the first half of the study period. Patients with COVID-19 who underwent endovascular thrombectomy had more frequently absent collaterals or collaterals filling ≤ 50% of the occluded territory (50.0% vs. 16.6%; OR 5.05; 95% CI 1.82-13.80) and a lower rate of good/complete recanalization of the primary arterial occlusive lesion (55.6% vs. 81.0%; OR 0.29; 95% CI 0.10-0.80). Post-procedural intracranial hemorrhages were more frequent (35.3% vs. 19.5%; OR 2.24; 95% CI 1.04-4.83) and outcome was worse among COVID-19 patients (in-hospital death, 38.2% vs. 8.8%; OR 6.43; 95% CI 2.85-14.50). Our findings showed longer delays in the intra-hospital management of acute ischemic stroke in COVID-19 patients, especially in the early phase of the outbreak, that likely impacted patients outcome and should be the target of future interventions.

Original languageEnglish
Pages (from-to)3561-3568
Number of pages7
JournalJ. Neurol.
Issue number10
Publication statusPublished - Mar 8 2021


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