Reorganizing stroke and neurological intensive care during the COVID-19 pandemic in Germany

Main Article Content

Niklas Alexander Kämpfer
Andrea Naldi
Nicola Luigi Bragazzi
Klaus Fassbender
Martin Lesmeister
Piergiorgio Lochner


COVID-19; neuro-ICU; healthcare reorganization and repurposing


The outbreak of coronavirus disease 19 (COVID-19) has dramatically imposed healthcare systems to reorganize their departments, including neurological wards. We aimed to describe the rearrangements made by stroke units (SU) and neurological intensive care units (ICU) in several German community and university hospitals facing the pandemic.

This cross-sectional, survey-based, nationwide study collected data of 15 university and 4 community hospitals in Germany, being part of IGNITE Study Group, from April 1 to April 6, 2020. The rearrangements and implementation of safety measures in SUs, intermediate care units (IMC), and neurological ICUs were compared.

84.2% of hospitals implemented a separated area for patients awaiting their COVID-19 test results and 94.7% had a dedicated zone for their management. Outpatient treatment was reduced in 63.2% and even suspended in 36.8% of the hospitals. A global reduction of bed capacity was observed. Hospitals reported compromised stroke treatment (52.6%) and reduction of thrombolysis and thrombectomy rates (36.8%). All hospitals proposed special training for COVID-19 management, recurrent meetings and all undertook measures improving safety for healthcare workers.

In an unprecedented global healthcare crisis, knowledge of the initial reorganization and response of German hospitals to COVID-19 may help finding effective strategies to face the ongoing pandemic.


Download data is not yet available.
Abstract 181 | PDF Downloads 99


Bersano A, Pantoni L: On being a neurologist in Italy at the time of the COVID-19 outbreak. Neurology Epub 2020 Apr 3. doi: 10.1212/WNL.0000000000009508
2. Helms J, Kremer S, Merdji H, et al: Neurologic Features in Severe SARS-CoV-2 Infection. N Engl J Med Epub 2020 Apr 15. doi: 10.1056/NEJMc2008597
3. Wu Y, Xu X, Chen Z, et al: Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun Epub 2020 Mar 30. doi: 10.1016/j.bbi.2020.03.031
4. Yashavantha Rao HC, Jayabaskaran C: The emergence of a novel coronavirus (SARS-CoV-2) disease and their neuroinvasive propensity may affect in COVID-19 patients. J Med Virol Epub 2020 Apr 22. doi: 10.1002/jmv.25918
5. Majersik JJ, Reddy VK: Acute neurology during the COVID-19 pandemic: Supporting the front line. Neurology Epub 2020 Apr 13. doi: 10.1212/WNL.0000000000009564
6. Baracchini C, Pieroni A, Viaro F, et al: Acute stroke management pathway during Coronavirus-19 pandemic. Neurol Sci 2020; 41: 1003–5. doi: 10.1007/s10072-020-04375-9
7. Khosravani H, Rajendram P, Notario L, Chapman MG, Menon BK: Protected Code Stroke: Hyperacute Stroke Management During the Coronavirus Disease 2019 (COVID-19) Pandemic. Stroke Epub 2020 Apr 1. doi: 10.1161/STROKEAHA.120.029838
8. Thomson GA: COVID-19: Leaving Lockdown - Of Schrodinger, Cats, Testing and Masks. Int J Clin Pract Epub 2020 Apr 21; e13519. doi: 10.1111/ijcp.13519
9. Cheung JC, Ho LT, Cheng JV, Cham EYK, Lam KN: Staff safety during emergency airway management for COVID-19 in Hong Kong. Lancet Respir Med 2020; 8: e19. doi: 10.1016/S2213-2600(20)30084-9
10. Radtke JS, Götz J, Gielen S, et al: [Bed capacity analysis for an intensive care unit: Retrospective analysis and projection for need of intensive care beds in over 65 year olds with selected cardiovascular diseases]. Article in German. Med Klin Intensivmed Notfmed Epub 2020 Feb 18. doi: 10.1007/s00063-020-00663-6

Most read articles by the same author(s)

1 2 > >>