Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic

Area of Science:

• Neurology
• Public Health
• Epidemiology

Background:

• Anecdotal evidence suggested a decline in hospital visits for stroke symptoms during the COVID-19 pandemic.
• This study aimed to quantify stroke code trends and patient characteristics during the pandemic's emergence.

Purpose of the Study:

• To analyze stroke code activity and patient data at three Connecticut hospitals during the COVID-19 pandemic.
• To compare stroke patient characteristics and process measures before and during the pandemic at a Comprehensive Stroke Center (CSC).

Main Methods:

• Stroke code data from January 1 to April 28, 2020, were compared with the same period in 2019.
• Statistical models were used to identify declines in stroke code frequency.
• Patient-level data from before and during the pandemic at a CSC were analyzed for demographic and clinical differences.

Main Results:

• A 30% decrease in total stroke codes was observed during the pandemic weeks in 2020 compared to 2019.
• Stroke code activity declined significantly starting in mid-February 2020.
• Pandemic-era stroke patients at the CSC were more likely to have specific comorbidities, public insurance, and live within the CSC city, but stroke severity and early outcomes did not differ.

Conclusions:

• Hospital presentations for stroke symptoms decreased during the COVID-19 pandemic.
• Despite decreased presentation, stroke severity and early outcomes remained consistent.
• Public health initiatives are crucial to encourage patients to seek care for non-COVID-19 emergencies like stroke during the pandemic.