Impact of COVID-19 on acute ischemic stroke presentation and prognosis in a county-level stroke center

The COVID-19 pandemic has influenced regular medical procedures and health-seeking behaviors. In this study, we aimed to investigate the influence of the COVID-19 pandemic on the presentation and prognosis of acute ischemic stroke (AIS) patients in county-level stroke centers.

We retrospectively collected AIS patients during the strict lockdown period (January 24, 2020, to March 27, 2020) and the corresponding "new normal" period (2021) of the COVID-19 pandemic. Patients seen during the same timeframe in 2019 were enrolled as controls. Statistical analysis was conducted to compare the clinical characteristics of AIS patients who presented during the lockdown and new normal periods and those who presented during the pre-COVID-19 pandemic period.

A total of 134 AIS patients presented during the lockdown period (the 2020 group), 207 patients in the pre-COVID-19 period (the 2019 group) and 201 patients in the "new normal" period (the 2021 group). Compared to the 2019 group, there was approximately 1/3 reduction in the number of patients who presented during the lockdown period, while the number of patients who received IVT or EVT was similar between the two groups. The number of patients, baseline characteristics, workflow intervals and clinical outcomes presented during the "new normal" period were similar between the 2019 and 2021 groups. Logistic regression showed that lockdown or new normal status were not risk factors associated with a poor outcome at 90 days.

In county-level city stroke centers, the COVID-19 lockdown resulted in a reduction in the number of patients with AIS admitted to the hospital but had no effect on patients treated with IVT or EVT. Lockdown or new normal status did not influence the prognosis of AIS patients.