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Coronavirus disease 2019 and stroke in Iran: a case series and effects on stroke admissions
M Mehrpour1, A Shuaib2, M Farahani3
1Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
The COVID-19 pandemic led to a 40% drop in stroke admissions. Stroke patients with COVID-19 were older and had more severe strokes, but treatments and outcomes remained similar.
Area of Science:
- Neurology
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic significantly impacted global healthcare systems.
- Stroke remains a leading cause of death and disability worldwide.
- Understanding the pandemic's effect on stroke care is crucial.
Purpose of the Study:
- To investigate the impact of the COVID-19 pandemic on stroke patient characteristics, treatment, and outcomes.
- To compare stroke admissions during the pandemic with previous periods.
- To analyze stroke severity and demographics in patients with and without COVID-19.
Main Methods:
- Retrospective analysis of 31 stroke patients during the COVID-19 pandemic.
- Comparison of demographic and pathological data between stroke patients with and without COVID-19.
- Evaluation of stroke patient data from the pandemic period against two non-pandemic periods.
Main Results:
- A 40% decrease in acute stroke admissions was observed during the pandemic.
- Stroke patients with COVID-19 were significantly older and had more severe strokes, particularly large vessel ischemic strokes.
- No significant differences were found in treatment approaches, hospitalization duration, or mortality rates.
Conclusions:
- The COVID-19 pandemic significantly reduced acute stroke admissions.
- COVID-19 infection in stroke patients was associated with increased age and stroke severity.
- Further research is needed to understand the interaction between COVID-19 and stroke.
Objective:
The coronavirus disease 2019 pandemic has affected healthcare systems around the globe and massively impacted patients with various non-infectious, life-threatening conditions. Stroke is a major neurological disease contributing to death and disability worldwide, and is still an ongoing issue during the pandemic. Here we investigate the impact of the coronavirus disease 2019 outbreak on stroke manifestations, treatment courses, the outcome of stroke patients, and the hospitalization rate in a referral center for stroke management in Tehran, Iran.
Methods:
We extracted data regarding 31 stroke patients (10 patients with laboratory-confirmed coronavirus disease 2019) and compared the demographic and pathological characteristics of the patients with or without coronavirus disease 2019 infection. The association of demographic/pathological characteristics of stroke patients during the coronavirus disease 2019 pandemic and a corresponding period during the previous year (49 patients) and an earlier period during the same year as the pandemic (50 patients) was also evaluated.
Results:
The absolute number of admissions decreased about 40% during the coronavirus disease 2019 pandemic. Except for the stroke severity (P = 0.002), there were no significant changes in the demographic and pathological characteristics of the stroke patients during the three studied periods. A significantly higher mean of age (75.60 ± 9.54 versus 60.86 ± 18.45; P = 0.007), a significant difference in the type of stroke (P = 0.046), and significantly higher stroke severity (P = 0.024) were observed in stroke patients with coronavirus disease 2019 compared with those of stroke patients without coronavirus disease 2019. Treatment approaches, duration of hospitalization, and mortality rates did not differ significantly.
Conclusions:
This report shows that the pandemic caused the number of acute stroke admissions to plummet compared to other periods. Although the pandemic did not affect the treatment plans and care of the patients, stroke cases with coronavirus disease 2019 had higher age, more large vessel ischemic stroke, and more severe stroke. Further studies are urgently needed to realize the probable interaction of the coronavirus disease 2019 pandemic and the neurologic disease.
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