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Table 6 Study characteristic

From: Mechanical thrombectomy (MT) for acute ischemic stroke (AIS) in COVID-19 pandemic: a systematic review

No. First author, country Study design Sample (n) Outcome measure Result
1. Al Kasab S; North and South America, Europe [45] Cross-sectional 458 The effect of GA on mortality and discharge outcome GA had longer door to reperfusion time (138 vs. 100 min, p < 0.001), higher mortality (RR: 1.871, p: 0.029), and lower functional outcome discharge (RR: 0.053, p: 0.015).
2. Cox M, USA [46] Cross-sectional 45 PCS in MT of AIS patients The importance of PCS implementation and the use of PPE during MT.
3. Escalard E, France [47] Case series 10 Patient outcome Successful MT was performed in 9 patients, none had good early neurological outcomes, and 6 patients died in the hospital.
4. Havenon A, USA [48] Cross-sectional 3145 Comparison of the outcome of MT in COVID-19 and non COVID-19 Mortality rate was increased significantly in AIS patients (treated with MT) with COVID-19 (29.8%) vs without COVID-19 (12.4%) (OR: 4.48, 95% CI: 3.02-6.165, p < 0.001). COVID-19 decreased a favorable hospital discharge (OR: 0.43, 95% CI: 0.3–0.61, p < 0.05).
5. Kerleroux B, France [28] Cross-sectional 1513 Comparison of MT in AIS patients before and during COVID-19 pandemic There was a 21% reduction in MT case (OR: 0.79, 95%CI: 0.76-0.82, p < 0.001), significant delays between imaging to puncture time (mean 144.9 ± 86.8 vs. 126.2 ± 70.9 min, p < 0.001 in 2019) and imaging to in-transferred patients (mean 182.6 ± 82.0 vs. 153.25 ± 67 min, p < 0.001), compared with the same period in 2019. There was a significant negative correlation between the number of COVID-19 hospitalizations and the number of MT cases compared with the same period in 2019 (r: 0.51, p: 0.04).
6. Kwan J, UK [49] Cross-sectional 61 Comparison of MT in AIS patients before and during COVID-19 pandemic During the COVID-19 pandemic, (a) MT rate was maintained at 20% of AIS and there was a non-significant 21% decrease in MT, referred from the external hospital (p: 0.067); (b) successful reperfusion rate was maintained at 81% and early neurological outcomes were not significantly different; (c) the use of general anesthesia reduced significantly from 85 to 32% (p < 0.05); and (d) time intervals from onset to arrival, puncture, and reperfusion were not significantly different, whereas internal delays for external referrals significantly increased for door to puncture time (48 [IQR 39–57] vs. 33 [IQR 27–44] minutes, p: 0.013) and door to reperfusion time (82.5 [IQR 61–110] vs. 60 [IQR 55–70] minutes, p: 0.018).
7. Mansour OY, Egypt [50] Case report 1 Patient outcome, PCS in MT of AIS patients The NIHSS score decreased to 2 after reperfusion (from 14 before MT). The importance of PCS implementation and the use of PPE during MT.
8. McConachie D, UK [51] Cross-sectional 27 Comparison of MT in AIS patients before and during COVID-19 pandemic Three centers did not perform MT, there was a 27.7% decrease of MT procedures in April 2020, and 22 centers reported delays of stroke care. 17 centers reported the reduction of training opportunities for specialist registrars and 14 centers reported the delay of development plans of MT service.
9. Pop R, France [52] Cross-sectional 122 Comparison of MT in AIS patients before and during COVID-19 pandemic There were 39.6% reduction of stroke alerts and 27.6% decrease in MT procedures in March 2020, compared to the same period in 2019. There were no significant differences in time delays or clinical outcomes for patients treated by MT.
10. Tiedt S, Germany [53] Cohort 795 Comparison of MT in AIS patients before and during COVID-19 pandemic There was prolonged door to groin time in 2020, compared with the same period in 2019 (47 min vs. 38 min, p: 0.005). Functional outcome of patients treated with MT in 2020 was not significantly different compared to patients treated in 2019 (p > 0.05).
11. Qureshi A I, USA [54] Cross-sectional 24 Comparison of MT in AIS patients before and during COVID-19 pandemic There was a significant reduction of MT procedures in March 2020 (p < 0.05).
12. Wang A, USA [19] Case series 5 Patient demographic, laboratory value, MT technique, and clinical and outcome 4 patients with COVID-19 had AIS with occlusion in anterior circulation and 1 patient with occlusions in anterior and posterior circulation, the average of age was 52.8 years, and all patients had coagulation abnormalities. Stent-aspiration combination technique was performed in all patients with poor clinical outcomes.
13. Yaeger K A, USA [55] Case series 10 Patient outcome Successful MT was performed in 9 patients with the NIHSS score decreased by an average of 7.7 points.
14. Yang B, China [29] Cross-sectional 55 Comparison of MT in AIS patients before and during COVID-19 pandemic There was significant increase in door to puncture time (174 vs. 125.5 min, p: 0.002) and door to reperfusion time (213 vs. 172 min, p: 0.047) in the COVID-19 pandemic, compared with the same period in 2019. The rate of successful MT was not significantly different between the two groups (85.7% (n = 18) vs. 88.2% (n = 30), OR 0.971, 95% CI: 0.785–1.203; p: 1.000).
15. Yeboah K, USA [56] Case report 1 Patient outcome, PCS in MT of AIS patients The NIHSS score decreased to 5 after reperfusion (from 14 before reperfusion) and reduced to 0 in day 2 post-reperfusion. The importance of PCS implementation and the use of PPE during MT.