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Social Distancing, Stroke Admissions and Stroke Mortality During the COVID-19 Pandemic: A Multicenter, Longitudinal

Pedro Cougo1, Bruno Besen2, Daniel Bezerra3

  • 1Hospital Vitória e Samaritano, Americas Serviços Medicos, United Health Group Brazil, Barra, Avenida Jorge Curi 550, Bloco A, Rio de Janeiro, RJ CEP 22775-001, Brazil.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|March 11, 2022
PubMed

Insights

Social distancing measures and high COVID-19 admission rates significantly impacted stroke admissions and mortality during the pandemic. Increased social distancing and COVID-19 cases correlated with higher stroke mortality.

Area of Science:

  • Neurology
  • Public Health
  • Epidemiology

Background:

  • The COVID-19 pandemic introduced unprecedented public health challenges, including widespread social distancing measures.
  • Understanding the impact of these measures and the pandemic itself on non-COVID-19 critical conditions, such as stroke, is crucial.

Purpose of the Study:

  • To evaluate the relationship between social distancing, stroke admissions, and stroke mortality during the COVID-19 pandemic.
  • To assess the influence of COVID-19 admission rates on stroke care outcomes.

Main Methods:

  • Longitudinal analysis of a prospective, multicenter hospital-based registry in Brazil over 14 months of the pandemic.
  • Investigated associations between daily stroke admission rates (DRAstroke), daily stroke mortality, social distancing index (SDI), and daily COVID-19 admission rates (DRACOVID) using regression models.
  • Compared clinical characteristics of stroke patients admitted before and during the pandemic.

Main Results:

  • A strong rise in SDI initially correlated with a significant decrease in DRAstroke.
  • Later in the pandemic, DRAstroke showed an inverse association with DRACOVID, even with minor SDI changes.
  • Higher SDI and DRACOVID were consistently linked to increased in-hospital stroke mortality throughout the pandemic.

Conclusions:

  • COVID-19 pandemic severity, particularly surges, independently and persistently reduced stroke admissions.
  • Declines in stroke admissions occurred even when social distancing policies were not intensified, suggesting broader pandemic effects.
  • Both social distancing and high COVID-19 caseloads negatively impacted stroke patient outcomes.
Abstract

Keywords:
Acute strokeCOVID-19EpidemiologySystems of care

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