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Updated: Dec 18, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Decrease in Hospital Admissions for Transient Ischemic Attack, Mild, and Moderate Stroke During the COVID-19 Era
Henrique Diegoli1, Pedro S C Magalhães1, Sheila C O Martins2
1From the Stroke Unit, Hospital São José, Joinville, Santa Catarina, Brazil (H.D., P.S.C.M., C.H.C.M., A.L.L.).
Insights
The COVID-19 pandemic led to a 36.4% decrease in stroke admissions, particularly for milder cases. This highlights the need to reorganize stroke care networks to mitigate collateral damage from the pandemic.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic raised concerns about reduced healthcare quality for non-COVID-19 conditions.
- Social restrictions and resource limitations during the pandemic may have impacted stroke care.
Purpose of the Study:
- To investigate the impact of the COVID-19 pandemic on stroke admissions in Joinville, Brazil.
- To analyze changes in stroke incidence, type, severity, and treatment following pandemic restrictions.
Main Methods:
- A population-based stroke registry was used to compare stroke admissions before and after March 17, 2020.
- Data from 2019 served as a baseline for comparison.
- Statistical analyses compared stroke incidence, severity (NIHSS >8), hemorrhage types, and reperfusion therapies.
Main Results:
- Total stroke admissions decreased by 36.4% (from 12.9 to 8.3 per 100,000 monthly).
- No significant differences were observed in admissions for severe strokes, intraparenchymal hemorrhage, or subarachnoid hemorrhage.
- Admissions for transient, mild, and moderate strokes significantly reduced.
Conclusions:
- The COVID-19 pandemic onset correlated with a reduction in admissions for less severe strokes.
- Reorganization of stroke care networks is crucial to prevent symptom worsening and complications in these patients.
- Addressing the collateral damage of COVID-19 on stroke care is essential.
Background And Purpose:
Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, doctors and public authorities have demonstrated concern about the reduction in quality of care for other health conditions due to social restrictions and lack of resources. Using a population-based stroke registry, we investigated the impact of the onset of the COVID-19 pandemic in stroke admissions in Joinville, Brazil.
Methods:
Patients admitted after the onset of COVID-19 restrictions in the city (defined as March 17, 2020) were compared with those admitted in 2019. We analyzed differences between stroke incidence, types, severity, reperfusion therapies, and time from stroke onset to admission. Statistical tests were also performed to compare the 30 days before and after COVID-19 to the same period in 2019.
Results:
We observed a decrease in total stroke admissions from an average of 12.9/100 000 per month in 2019 to 8.3 after COVID-19 (P=0.0029). When compared with the same period in 2019, there was a 36.4% reduction in stroke admissions. There was no difference in admissions for severe stroke (National Institutes of Health Stroke Scale score >8), intraparenchymal hemorrhage, and subarachnoid hemorrhage.
Conclusions:
The onset of COVID-19 was correlated with a reduction in admissions for transient, mild, and moderate strokes. Given the need to prevent the worsening of symptoms and the occurrence of medical complications in these groups, a reorganization of the stroke-care networks is necessary to reduce collateral damage caused by COVID-19.
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