Stroke care during the Covid‐19 pandemic: Experience from three large European countries

Bersano, Anna; Kraemer, Markus; Touzé, Emmanuel; Weber, Ralph; Alamowitch, Sonia; Sibon, Igor; Pantoni, Leonardo

To cope with the exponentially increasing number of patients infected by SARS‐Cov‐2, European countries carried out enormous efforts to reorganize medical assistance, and several diseases, including stroke, were particularly impacted. Herein, we report the experience of stroke neurologists from three European countries, Italy, France and Germany, that faced the pandemic at diverse time points and with different approaches, depending on their resources and health care system organization. Pre‐hospital and in‐hospital acute stroke pathways were reorganized to prioritize COVID‐19 management, and, in severely affected regions of Italy and France, stroke care was centralized to a limited number of centers while remaining stroke units were dedicated to COVID‐19 patients. The access to acute stroke diagnostics and time dependent therapies was limited or delayed because of reduced capacities of emergency services due to the burden of COVID‐19 patients. A marked reduction in the number of patients presenting with TIA and stroke was noted in the emergency departments of all three countries. Although we have only preliminary data, overall these conditions may have affected stroke outcome. These indirect effects of COVID‐19 pandemic could vanish the last years' efforts of stroke neurologists to improve outcome and reduce mortality of stroke patients. Although SARS‐Cov‐2 infection rate is slowing down in Europe, the effects of the ending lockdown in the next months are unpredictable. It is important for the European and world stroke community to share the experience learned so far to prepare for the next future and upcoming challenging times in the care of stroke patients.