@article {Alonso de Leci{\~n}anasvn-2020-000678, author = {Mar{\'\i}a Alonso de Leci{\~n}ana and Mar Castellanos and {\'O}scar Ayo-Mart{\'\i}n and Ana Morales}, editor = {, and , and Fern{\'a}ndez P{\'e}rez, Mar{\'\i}a Dolores and Corral, Esther Gallardo and S{\'a}nchez, Patricia Mart{\'\i}nez and Moniche, Francisco and Oropesa, Juan Manuel and S{\'a}nchez, Soledad P{\'e}rez and Rosso, Raul Espinosa and Tamayo Toledo, Jose Antonio and Moyano, Roberto Valverde and Juste, Carlos Tejero and Meza, Herbert Tejada and Mart{\'\i}nez, Elena L{\'o}pez-Cancio and Men{\'e}ndez, Ignacio Casado and Martinez, M Carmen Jimenez and Rodriguez, Antonio Medina and L{\'o}pez Fernandez, Juan Carlos and Palacio Portilla, Enrique Jes{\'u}s and Arenillas Lara, Juan Francisco and Garc{\'\i}a, Javier Tejada and Anguiano, Yolanda Bravo and Ferrero Ros, Marta and Segundo Rodriguez, Jose C and Cardona, Pere and Gonz{\'a}lez, Jaume Roquer and Cuesta, Manuel Jesus G{\'o}mez-Choco and Fabregas, Joan Marti and Leal, Joaqu{\'\i}n Serena and Purroy, Francisco and Delgado, Sergi Amaro and Pagola, Jorge and Hernandez, Nicolas Lopez and Tienda, Alejandro Ponz De and Soriano, Cristina Soriano and Ferrair{\'o}, Jos{\'e} Tembl and Naranjo, Ignacio Casado and Moreno, Jose M Ramirez and Montero, Jose Luis Maci{\~n}eiras and Castro, Emilio Rodr{\'\i}guez and Ruiz, Joaquin Carneado and Casta{\~n}o, Patricia Calleja and Egido Herrero, Jose Antonio and Pastor, Andres Garcia and Mimbrera, Alicia De Felipe and Tejada, Araceli Garc{\'\i}a and Rodr{\'\i}guez, Marta Guill{\'a}n and Esteban, Laura Izquierdo and Rode{\~n}o, Beatriz Oyanguren and Rico, {\'A}lvaro Xim{\'e}nez-Carrillo and S{\'a}nchez-Vizca{\'\i}no, Cristina and Isasi, Mar{\'\i}a Herrera and Sieira, Pablo Irimia and Guerrero, Mar Freijo and Zabaleta, Maite Mart{\'\i}nez and S{\'a}nchez, Juan Manuel Garc{\'\i}a}, title = {Stroke care during the COVID-19 outbreak in Spain: the experience of Spanish stroke units}, elocation-id = {svn-2020-000678}, year = {2020}, doi = {10.1136/svn-2020-000678}, publisher = {BMJ Specialist Journals}, abstract = {Background and purpose Spain has been heavily affected by COVID-19. Reallocation of resources for managing the outbreak might have caused a disruption in stroke care. This study analyses the impact on stroke care of reorganising the healthcare system in response to the first COVID-19 outbreak peak in Spain and the strategies adopted by Spanish stroke units to deal with this impact.Materials and methods We obtained data from a structured survey sent to the responsible of stroke units across the country. We recorded the number of strokes, stroke code activations, intravenous thrombolysis treatments and mechanical thrombectomies during February and March 2019 and 2020. We also collected information on the impact on workflow metrics and on the availability of specialised neurological care and rehabilitation treatments, the characteristics of stroke care for patients with SARS-CoV-2 infection and the impact on human resources. We compared the activity data between 2019 and 2020 and the information on activity and impact on stroke care between regions classified according to the disease incidence rate.Results Fifty-seven (75\%) of all stroke units in Spain responded to the survey. There was an overall reduction in admissions for all stroke types during the outbreak{\textquoteright}s peak and in the number of stroke code activations and intravenous thrombolysis treatments, results that were independent of the COVID-19 incidence rate. Participants reported a delay in workflow metrics and a reduction of admissions to stroke units, outpatient clinics and rehabilitation therapies. Specific pathways and protocols for managing stroke patients with SARS-CoV-2 infection have been established.Conclusion The COVID-19 outbreak has jeopardised all phases of stroke care. As a consequence, some patients with stroke did not receive adequate treatment.}, issn = {2059-8688}, URL = {https://svn.bmj.com/content/early/2020/12/04/svn-2020-000678}, eprint = {https://svn.bmj.com/content/early/2020/12/04/svn-2020-000678.full.pdf}, journal = {Stroke and Vascular Neurology} }