{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:06:23Z","timestamp":1787799983541,"version":"build-2784847793"},"reference-count":13,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2020,8,3]],"date-time":"2020-08-03T00:00:00Z","timestamp":1596412800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. J. Neurol. Sci."],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>ABSTRACT:<\/jats:title><jats:sec id=\"S0317167120001705_as1\"><jats:title>Background:<\/jats:title><jats:p>We investigated the impact of regionally imposed social and healthcare restrictions due to coronavirus disease 2019 (COVID-19) to the time metrics in the management of acute ischemic stroke patients admitted at the regional stroke referral site for Central South Ontario, Canada.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167120001705_as2\"><jats:title>Methods:<\/jats:title><jats:p>We compared relevant time metrics between patients with acute ischemic stroke receiving intravenous tissue plasminogen activator (tPA) and\/or endovascular thrombectomy (EVT) before and after the declared restrictions and state of emergency imposed in our region (March 17, 2020).<\/jats:p><\/jats:sec><jats:sec id=\"S0317167120001705_as3\"><jats:title>Results:<\/jats:title><jats:p>We identified a significant increase in the median door-to-CT times for patients receiving intravenous tPA (19 min, interquartile range (IQR): 14\u201327 min vs. 13 min, IQR: 9\u201317 min, <jats:italic>p<\/jats:italic> = 0.008) and\/or EVT (20 min, IQR: 15\u201333 min vs. 11 min, IQR: 5\u201320 min, <jats:italic>p<\/jats:italic> = 0.035) after the start of social and healthcare restrictions in our region compared to the previous 12 months. For patients receiving intravenous tPA treatment, we also found a significant increase (<jats:italic>p<\/jats:italic> = 0.005) in the median door-to-needle time (61 min, IQR: 46\u201372 min vs. 37 min, IQR: 30\u201350 min). No delays in the time from symptom onset to hospital presentation were uncovered for patients receiving tPA and\/or endovascular reperfusion treatments in the first 1.5 months after the establishment of regional and institutional restrictions due to the COVID-19 pandemic.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167120001705_as4\"><jats:title>Conclusion:<\/jats:title><jats:p>We detected an increase in our institutional time to treatment metrics for acute ischemic stroke patients receiving tPA and\/or endovascular reperfusion therapies, related to delays from hospital presentation to the acquisition of cranial CT imaging for both tPA- and EVT-treated patients, and an added delay to treatment with tPA.<\/jats:p><\/jats:sec>","DOI":"10.1017\/cjn.2020.170","type":"journal-article","created":{"date-parts":[[2020,8,3]],"date-time":"2020-08-03T07:48:58Z","timestamp":1596440938000},"page":"59-65","source":"Crossref","is-referenced-by-count":38,"title":["In-Hospital Delays for Acute Stroke Treatment Delivery During the COVID-19 Pandemic"],"prefix":"10.1017","volume":"48","author":[{"given":"Aristeidis H.","family":"Katsanos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"de Sa Boasquevisque","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa Ahmed","family":"Al-Qarni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mays","family":"Shawawrah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhonda","family":"McNicoll-Whiteman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Gould","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Van Adel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demetrios J.","family":"Sahlas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelvin Kuan Huei","family":"Ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanjana","family":"Perera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukul","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wieslaw","family":"Oczkowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Pikula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashkan","family":"Shoamanesh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana","family":"Catanese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2020,8,3]]},"reference":[{"key":"S0317167120001705_ref9","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.029838"},{"key":"S0317167120001705_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.104927"},{"key":"S0317167120001705_ref5","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.030329"},{"key":"S0317167120001705_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2013.01.004"},{"key":"S0317167120001705_ref3","doi-asserted-by":"publisher","DOI":"10.1017\/cjn.2020.74"},{"key":"S0317167120001705_ref6","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.030373"},{"key":"S0317167120001705_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2020.03.013"},{"key":"S0317167120001705_ref4","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.030225"},{"key":"S0317167120001705_ref11","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.030106"},{"key":"S0317167120001705_ref2","doi-asserted-by":"publisher","DOI":"10.1177\/1747493020923472"},{"key":"S0317167120001705_ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2001017"},{"key":"S0317167120001705_ref12","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.030091"},{"key":"S0317167120001705_ref7","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.030105"}],"container-title":["Canadian Journal of Neurological Sciences \/ Journal Canadien des Sciences Neurologiques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0317167120001705","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T08:33:29Z","timestamp":1611045209000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0317167120001705\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,3]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["S0317167120001705"],"URL":"https:\/\/doi.org\/10.1017\/cjn.2020.170","relation":{},"ISSN":["0317-1671","2057-0155"],"issn-type":[{"value":"0317-1671","type":"print"},{"value":"2057-0155","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,3]]}}}