Impact of COVID-19 outbreak on the quality of care and outcomes for in-hospital patients with acute ischemic stroke in china

Background: It is unclear the impact of the COVID-19 pandemic on the health care and outcomes for in-hospital patients with acute ischemic stroke (AIS) We aimed to evaluate the influence of COVID-19 on the quality of care for in-hospital patients with AIS Methods: This is an observational registry study between November 23rd, 2019 and March 22nd, 2020 408 hospital from 29 provinces in China were enrolled from Chinese Stroke Center Alliance (CSCA) Patients with AIS were extracted with demographic, clinical and previous history information We focus on the time period before and after January 23rd, 2020, when the public health interventions were carried out in China The primary outcome was adherence to 11 performance measures, with co-primary outcomes of a composite of percentage of performance measures adhered to Secondary outcomes included were time measures and in-hospital outcomes Results: 42056 patients with AIS was enrolled (mean age 66 5±12 1, male 61 3%) The overall inhospital patients decreased slightly from 14323 to 14204 before the COVID-19 outbreak and went down sharply by 31 4% and 61 1% after the outbreak and the public conducted interventions in China A remarkable reduction was shown in patients with NIHSS score ≤ 3 from 57 7% to 55 7% after the outbreak (p< 001) Adherence to performance kept steady and grew slightly overall, for the composite measure (0 78±0 19 vs 0 79±0 18, p< 001) increased after the COVID-19 outbreak Discharged against medical advice increased from 5 9% to 7 3% after the outbreak (p< 001) The length of stay fell as expected after the public health interventions (10 0 (7 0-13 0) vs 9 0 (7 0-13 0), p< 001) Conclusions: The admission number of patients with AIS declined significantly after the COVID-19outbreak, but the quality of care and outcomes kept stable Hospitals should admit AIS patients tothe fullest extent of ability and provide tailored treatment strategies under the premise of no thecross-infection of COVID-19