Impact of SARS-CoV-2 Pandemic on "Stroke Code" Imaging Utilization and Yield.

Area of Science:

• Neurology
• Public Health
• Radiology

Background:

• The Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) pandemic led to indirect health consequences, including delayed medical attention for various conditions.
• Patients' reluctance to seek care impacted the presentation and diagnosis of diseases unrelated to the pandemic.

Purpose of the Study:

• To analyze changes in stroke code imaging during the early months of the SARS-CoV-2 pandemic.
• To compare stroke code imaging data from 2020 with matched prepandemic months in 2019.

Main Methods:

• A retrospective review of stroke codes was conducted, comparing pandemic months in 2020 with identical months in 2019.
• Patient data included age, sex, hospital location, and National Institutes of Health Stroke Scale (NIHSS) scores.
• Imaging results from CT, CTA, CTP, and MR examinations were reviewed to determine positivity rates.

Main Results:

• A statistically significant decrease in monthly stroke code volumes was observed during the pandemic.
• There was a significant increase in the proportion of positive imaging findings, average NIHSS scores, and inpatient stroke codes during the pandemic.
• These changes were statistically significant when compared to both prior year and same-year prepandemic months.

Conclusions:

• The pandemic period saw fewer stroke codes but a higher proportion of positive imaging results, increased symptom severity, and more inpatient cases.
• This trend is attributed to patients delaying medical care during the pandemic.
• The rise in inpatient stroke codes may indicate an increase in neurologic complications directly related to SARS-CoV-2 infection.