Impact of COVID-19 on telestroke

Background and Aims: Current global pandemic situation may influence acute stroke management. In the Comunity of Madrid, a solid organization between stroke units (SU) and changes to ensure patients acces to recanalization therapies have demonstrated similar rates of tPA administration and/or thrombectomy during the first wave. But COVID 19 impact on Telestroke in our Comunity has not been evaluated. Our aim is to evaluate changes in Telestroke management and results in terms of access to SU and recanalization therapies comparing the prepandemic and pandemic period. Methods: Retrospective analisis of patients evaluated between March 2019 and March 2021 through Telestroke. Comparison of casuistics since the pandemic (March 2020-February 2021) compared to previous period (March 2019-February 2020). Evaluation of number of recanalization therapies, Stroke Unit hospitalizations and other clinical parameters. Results: There has been a non-significant reduction of Telestroke activation for the pandemic period (175 vs 199 patients). Transfers and SU hospitalization also decreased for the second period. Rates of recanalization therapies remained stable (16% por tPA administration and 6% for thrombectomy). Rates of stroke mimics and clinical parameters did not differ between groups. Concomitant COVID 19 infeccion was not associated to poorer management in terms of acces to SU or recanalization therapies. Conclusions: COVID 19 situation has an impact on Telestroke management, by decreasing number of transfers to SU, but recanalization therapies remained stable. Telestroke is a useful tool for acute stroke evaluation and treatment, increasing equity to access to specialized care and avoids transfers in a situation where resources saving is essential.