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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Stroke
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1488529
This article is part of the Research Topic Quality of Stroke Care: What Could Be Improved, and How? - Volume II View all 3 articles

Impact of in-hospital COVID-19 quarantine policy changes on quality of acute stroke care: A single center experience

Provisionally accepted
Minkyung Kim Minkyung Kim 1Seong-Eun Kim Seong-Eun Kim 2Hokyu Kim Hokyu Kim 1Han Jun Kim Han Jun Kim 1Jung Hoon Han Jung Hoon Han 1Kyungmi Oh Kyungmi Oh 1Sung-Jun Park Sung-Jun Park 3Chi Kyung (CK) Kim Chi Kyung (CK) Kim 1Keon-Joo Lee Keon-Joo Lee 1*Young-Duck Cho Young-Duck Cho 3
  • 1 Department of Neurology, Guro Hospital, Korea University, Seoul, Republic of Korea
  • 2 Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
  • 3 Department of Emergency Medicine, College of Medicine, Korea University, Seoul, Republic of Korea

The final, formatted version of the article will be published soon.

    Introduction: The COVID-19 pandemic is known to impact in-hospital processes for acute stroke patients, potentially resulting in delays due to quarantine and screening measures. The purpose of this study was to determine effects of changes in in-hospital quarantine policies on quality of care for acute stroke patients. Methods: Hyperacute ischemic stroke patients who were admitted to Korea University Guro Hospital between January 2019 and February 2021 via the emergency department were included in this study. All had neurological symptoms within six hours before arrival. As a mandatory COVID-19 real-time PCR screening test was implemented in March 2020, changes in quality indicators according to the progress of COVID-19 pandemic and changes in in-hospital quarantine policy, including door-to-image time (DIT), door-to-referral time, door-to-needle time (DNT), door-to-puncture time (DPT), and functional outcomes (discharge and 3-month modified Rankin's scale) were determined. Results: A total of 268 hyperacute stroke patients were analyzed. The number of hyperacute stroke patients gradually decreased as the pandemic progressed. Time indicators, including door-to-referral time, DIT, and DPT during the pandemic were increased. When pre-and post-COVID-19 screening epochs were compared, DIT, door-to-neurologist referral time, and DPT showed numerical increases. However, after accounting for potential confounders, a significant delay in DIT was found to be associated with the in-hospital COVID-19 quarantine policy. Discussion: Our study showed that enhancing in-hospital COVID-19 quarantine measures might increase the response time for hyperacute stroke care, suggesting an impact on the quality of care.

    Keywords: COVID-19, Stroke, ischemic stroke, quality of care, Quarantine

    Received: 30 Aug 2024; Accepted: 18 Dec 2024.

    Copyright: © 2024 Kim, Kim, Kim, Kim, Han, Oh, Park, Kim, Lee and Cho. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Keon-Joo Lee, Department of Neurology, Guro Hospital, Korea University, Seoul, Republic of Korea

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.