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COVID-19 and stroke: Experience in a Ghanaian healthcare system

Fred S Sarfo1, Naa Oboshie Mensah2, Francis Agyapong Opoku2

  • 1Department of Medicine, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana; Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.

Journal of the Neurological Sciences
|July 24, 2020
PubMed

Insights

The COVID-19 pandemic saw increased stroke admissions and recurrent strokes in Ghana. Stroke case fatality also trended higher, highlighting the need for ongoing surveillance and research in sub-Saharan Africa.

Area of Science:

  • Neurology
  • Public Health
  • Infectious Diseases

Background:

  • The novel coronavirus disease (COVID-19) is a multi-system illness potentially increasing stroke risk.
  • Data from high-income countries indicate care delivery disruptions and reduced stroke treatment during the pandemic.
  • There is a lack of data on COVID-19's impact on stroke admissions and outcomes in sub-Saharan Africa.

Purpose of the Study:

  • To compare stroke admission and case fatality rates in Ghana during 2020 versus 2019.
  • To assess the potential impact of the COVID-19 pandemic on stroke care in Ghana.

Main Methods:

  • A comparative analysis of monthly stroke admissions and mortality rates was conducted.
  • Data from January to June 2020 were compared with the same period in 2019 at a tertiary hospital in Ghana.
  • Multivariate logistic regression was used to identify predictors of in-patient mortality.

Main Results:

  • Stroke admissions increased by 7.5% in January-June 2020 compared to 2019 (431 vs. 401).
  • Recurrent stroke admissions significantly rose in 2020 (19.0% vs. 10.9%, p=0.0026).
  • Stroke case fatality trended higher in 2020 (29.3% vs. 24.2%, p=0.095), with an adjusted odds ratio of 1.22 for mortality.

Conclusions:

  • The COVID-19 pandemic coincided with increased initial and recurrent stroke admissions at a Ghanaian tertiary hospital.
  • While secular trends may play a role, the pandemic's influence on stroke admissions requires further investigation.
  • Continued surveillance and broader assessment across African sites are recommended to understand the pandemic's impact on stroke care.
Abstract

Keywords:
AfricaCOVID-19MortalityRecurrenceStroke admissions

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