Treatment and outcome of acute stroke during the COVID-19 outbreak
The «Schweizerische Herzstiftung» has granted funding to the research group by Prof. Leo Bonati for the project "Impact of the COVID-19 outbreak on pathomechanisms, treatment, and outcome of acute stroke at Stroke Units and Stroke Centers in Switzerland", which was developed in collaboration with the DKF.
For this project, data from the Swiss Stroke Registry (SSR) will be analysed in more depth to find answers to COVID-19 relevant questions in regard to stroke patients.
All investigators:
- DKF: Gilles Dutilh, PhD, PD Lars G. Hemkens, Prof. Christiane Pauli-Magnus, Patrick R. Wright, PhD
- Neurology, USB: Prof. Leo H. Bonati, PD Gian Marco De Marchis
- Department of Neurology, University Hospital and University of Bern: Prof. Marcel Arnold, Prof. Urs Fischer, Prof. Simon Jung, PD David Seiffge
- Department of Neurology, University Hospital and University of Lausanne: Prof. Patrik Michel, Dr. Davide Strambo
Since 2014, all Swiss hospitals certified in stroke therapy have been recording standardized data of patients with acute stroke, cerebral hemorrhage and other cerebrovascular diseases in the SSR. The aim of the register is to provide important answers to questions directly relevant to patients. In total, almost 70,000 cases have been recorded in the SSR since 2014. The data center of the SSR is located at the DKF. Patrick Wright, PhD, Senior Data Scientist at the DKF is responsible for this data center. Together with Prof. Leo Bonati, he also developed the idea of using this data in the context of the COVID-19 pandemic in coordination with all project partners from Swiss hospitals and stroke centers.
The lockdown has had a massive impact on everyday life in Switzerland. There has been ongoing discussion about the extent to which certain measures also affect medical care as a whole. For example, stroke experts have observed a decline in the number of patients with ischaemic stroke, intracerebral haemorrhage and patients with transient ischaemic attacks in some hospitals since the beginning of the pandemic. However, it is unclear whether these changes are due to the pandemic or whether they are within the normal range of fluctuation. In addition to possible changes in patient behaviour, the provision of stroke care in hospitals may also have been affected by the redirection of staff and infrastructure due to the pandemic. For example, some stroke units have been converted into COVID-19 wards and personnel have been assigned to treat COVID-19 patients.
Beyond this, many effects of COVID-19 on the cardiovascular system remain unclear. With regard to strokes, various specific pathomechanisms are conceivable. For example, smaller studies provide information on the influence of the disease on blood coagulation and on the development of endothelial dysfunction. Both are factors also associated with cerebrovascular diseases.