INTRODUCTION: During the COVID-19 pandemic, studies reported less number of hospitalizations for acute stroke and reduction in the use of recanalization treatments. This study analyzes nationwide data on stroke admissions and management in the Czech Republic during the first wave of the COVID-19 pandemic. METHODS: We compared the early COVID-19 pandemic (March-May 2020) with the pre-pandemic period (January-February 2020 and March-May 2019): (a) the National Register of Reimbursed Health Services provided volume of all admissions for subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), and ischemic stroke (IS), and volume of recanalization treatments (intravenous thrombolysis [IVT] and mechanical thrombectomy [MT]); (b) Registry of Stroke Care Quality provided door-to-needle time (DNT), onset-to-door time (ODT), and stroke severity at admission (National Institutes of Health Stroke Scale, NIHSS) for IS. RESULTS: During the pandemic (March-May 2020), the peak number of COVID-19 patients treated in Czech hospitals was 39 per million. In March-May 2020 versus March-May 2019, hospital admissions decreased as follows: stroke overall by 14% (p < 0.001), IS by 14% (p < 0.001), SAH by 15% (p = 0.07), and ICH by 7% (p = 0.17). The mean age was 74 years versus 74 years (p = 0.33), and 52% versus 51% were men (p = 0.34). The volumes of IVT and MT decreased by 14% (p = 0.001) and 19% (p = 0.01), respectively. The proportions of all IS patients receiving IVT or MT remained unchanged, with, respectively, 17% versus 17% receiving IVT (p = 0.86) and 5% versus 5% receiving MT (p = 0.48). DNT and ODT were 24 versus 25 min (p = 0.58) and 168 versus 156 min (p = 0.23), respectively. NIHSS at admission did not differ (6 vs. 6; p = 0.54). CONCLUSION: Even with a low burden of COVID-19 during the first wave and no change in organization and logistics of stroke services, stroke admissions and volume of recanalization treatments decreased. Public health communication campaigns should encourage people to seek emergency medical care for stroke symptoms during the COVID-19 pandemic.

• Klíčová slova
• COVID-19, Czech Republic, Intravenous thrombolysis, Mechanical thrombectomy, Stroke,
• MeSH
• cévní mozková příhoda * terapie   MeSH
• COVID-19 * epidemiologie   terapie   MeSH
• lidé MeSH
• pandemie * MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

OBJECTIVE: To create an informatics supportive tool, which can assist healthcare professionals in estimating potential requirements for essential drug supplies to respond to the current SARS-CoV-2 pandemic based on epidemiological forecasting. METHODS: The tool was based on a Susceptible-Infected-Removed (SIR) epidemiological model in which the population is divided into three compartments and transmission parameters are specified to define the rate at which people move between stages. Appropriate data entry was guaranteed by the creation of structured guided paths. The drugs needed for the forecasted patients were estimated according to a list of critical care drugs compiled by consulting previous published scientific works, national and international guidelines. For each drug, an estimation was made of the percentage average ICU uptake for each therapeutic group and active principle. RESULTS: The tool consists of a Microsoft Excel template that is based on the initial epidemiological situation, the non-pharmaceutical interventions applied, the risk of hospitalisation based on the population age distribution, and the hospital beds available. The tool provides a forecast of which patients with COVID-19 will need to be treated in a hospital setting. The number of patients is used to estimate the drugs needed based on the average daily dose and the treatment length of each drug. The possibility of editing the type of distribution (exponential or linear) of the number of patients at the beginning of the analysis, the percentage adherence with non-pharmaceutical interventions and their delayed effect, and all the key epidemiological parameters make the estimation tailorable to different clinical contexts and needs. CONCLUSIONS: This model might be an effective supporting tool that could be easily implemented within the workflow of health professionals. All the information reported in this paper could be useful in developing new strategies to tackle the COVID-19 pandemic.

• Klíčová slova
• CLINICAL MEDICINE, COVID-19, Medical Informatics, critical care, health care economics and organizations, health care rationing, practice guideline, public health,
• MeSH
• COVID-19 * MeSH
• hospitalizace MeSH
• lidé MeSH
• pandemie * MeSH
• péče o pacienty v kritickém stavu MeSH
• SARS-CoV-2 MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

In the Czech Republic, the current pandemic led to over 1.67 million SARS-CoV-2- positive cases since the recording of the first case on 1 March 2020. SARS-CoV-2 genome analysis is an important tool for effective real-time quantitative PCR (RT-qPCR) diagnostics, epidemiology monitoring, as well as vaccination strategy. To date, there is no comprehensive report on the distribution of SARS-CoV-2 genome variants in either the Czech Republic, including Central and Eastern Europe in general, during the first year of pandemic. In this study, we have analysed a representative cohort of SARS-CoV-2 genomes from 229 nasopharyngeal swabs of COVID-19 positive patients collected between March 2020 and February 2021 using validated reference-based sequencing workflow. We document the changing frequency of dominant variants of SARS-CoV-2 (from B.1 -> B.1.1.266 -> B.1.258 -> B.1.1.7) throughout the first year of the pandemic and list specific variants that could impact the diagnostic efficiency RT-qPCR assays. Moreover, our reference-based workflow provided evidence of superinfection in several samples, which may have contributed to one of the highest per capita numbers of COVID-19 cases and deaths during the first year of the pandemic in the Czech Republic.

• Klíčová slova
• SARS-CoV-2, massively parallel sequencing, metagenomics, phylogeny, variants,
• Publikační typ
• časopisecké články MeSH