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Published on: May 22, 2019
Ischaemic stroke in the time of coronavirus disease 2019
H Tejada Meza1,2, Á Lambea Gil1, A Sancho Saldaña1
1Stroke Unit, Department of Neurology, Hospital Universitario Miguel Servet, Zaragoza, Spain.
Insights
The COVID-19 pandemic significantly reduced hospital admissions for ischemic stroke, with fewer patients seeking emergency care. Treatment rates remained stable, but the time from symptom onset to hospital arrival increased.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- The COVID-19 pandemic has impacted healthcare systems globally.
- Changes in patient influx to emergency departments are a concern.
- No data quantified the impact on stroke admissions during the pandemic.
Purpose of the Study:
- To analyze the effect of the COVID-19 outbreak on hospital admissions for ischemic stroke.
- To assess changes in stroke patient characteristics during the pandemic.
Main Methods:
- Retrospective review of ischemic stroke patients admitted between December 2019 and April 2020.
- Comparison of demographic and clinical data before and after the COVID-19 state of emergency.
Main Results:
- A significant decrease in weekly average stroke admissions was observed (27.5 before vs. 12 after).
- No significant differences in rates of intravenous thrombolysis or endovascular therapy.
- Increased median onset-to-door time (102 min vs. 183 min).
Conclusions:
- The COVID-19 outbreak led to a global decrease in stroke events.
- This reduction occurred broadly without specific patient distribution.
- Delayed hospital arrival times were noted, potentially impacting stroke care outcomes.
Background And Purpose:
Stroke assistance is facing changes and new challenges since COVID-19 became pandemic. A variation on the patient influx might be one of the greater concerns, due to fewer people coming to emergency departments or coming too late. However, no data quantifying this have been published until now. The aim was to analyse the impact of the COVID-19 epidemic outbreak on hospital stroke admissions and their characteristics in our region.
Methods:
The data of every patient admitted to any hospital of our healthcare system with a diagnosis of ischaemic stroke between 30 December 2019 and 19 April 2020 were reviewed. Demographic and clinical data were recorded and compared between periods before and after the setting of the state of emergency secondary to the COVID-19 outbreak.
Results:
In total, 354 patients with ischaemic stroke were admitted in our study period. There was a weekly average of 27.5 cases before the setting of the state of emergency against 12 afterwards (P < 0.001). This drop in stroke cases occurred progressively from week 11, persisting in time despite the decrease in confirmed cases of COVID-19. No differences in the proportion of intravenous thrombolysis (21.1% vs. 21.5%, P = 0.935) or endovascular therapy (12.4% vs. 15.2%, P = 0.510) were found, nor in other demographic or clinical characteristics except for median onset-to-door time (102 vs. 183 min, P = 0.015).
Conclusions:
This observational study offers the perspective of a whole region in one of the countries more heavily stricken by the SARS-CoV-2 epidemic and shows that the decrease of stroke events, since the beginning of the COVID-19 outbreak, happened globally and without any specific patient distribution.
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