Related Experiment Video
Updated: Aug 22, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
COVID-19 and Stroke Trends in A Tertiary Care Center from South India -Our Monsoon Experience
Dileep Ramachandran1, Githin Benoy George1, Praveen Panicker1
1Departments of Neurology, Government Medical College, Thiruvananthapuram, Kerala, India.
Insights
The COVID-19 pandemic worsened acute stroke care, leading to treatment delays and poorer outcomes. COVID-19-positive stroke patients experienced more severe strokes, higher mortality, and worse functional recovery.
Area of Science:
- Neurology
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic significantly disrupted healthcare, impacting acute stroke management and raising concerns about co-infection effects.
- Delayed treatment metrics and potential adverse outcomes in stroke patients during the pandemic required urgent investigation.
Purpose of the Study:
- To investigate the impact of COVID-19 on acute stroke management.
- To compare stroke characteristics, etiology, treatment, and outcomes in COVID-19 positive versus negative patients.
Main Methods:
- A single-center retrospective study included acute stroke patients presenting within 24 hours.
- Data collected from May-July 2020 (pandemic) and May-July 2019 (pre-pandemic) included demographics, risk factors, NIHSS, timings, thrombolysis rates, etiology, mRS, and mortality.
Main Results:
- Pandemic strokes showed higher NIHSS, blood sugar, blood pressure, and delays in door-to-CT/needle times.
- COVID-19 positive strokes had less IV thrombolysis, more hemorrhagic strokes, lower ASPECTS scores, higher mortality, and poorer functional outcomes.
Conclusions:
- The pandemic, particularly COVID-19 co-infection, is associated with increased stroke severity and mortality.
- Findings highlight the critical need for optimized stroke care pathways during public health crises.
Introduction:
The unprecedented challenges during the COVID pandemic and the subsequent lockdown had resulted in a delay in treatment metrics for acute stroke. There is a rising concern that COVID-19 co-infection can adversely affect stroke outcome. We aim to investigate the impact of COVID-19 in the management of stroke patients. We also compared the differences in stroke manifestations, etiological pattern, treatment course, and outcome of acute stroke patients in COVID-19 confirmed cases.
Methodology:
A single-center retrospective study was done at the Stroke Unit, Government Medical College, Thiruvananthapuram. Consecutive patients of acute stroke confirmed by imaging, presenting within 24 hours of the onset of symptoms in May to July 2020 and May to July 2019, were included. The primary data variables included baseline demographics, risk factors, admission NIHSS, stroke timings, thrombolysis rate, TOAST etiology, mRS at discharge, and in-hospital mortality.
Results:
Strokes with higher NIHSS, arrival blood sugar and blood pressure, and delays in door-to-CT and door-to-needle time were more during the pandemic. Intravenous thrombolysis was less and mortality was higher in COVID-19 strokes during the pandemic. COVID-19-positive stroke patients had more hemorrhagic strokes, more severe strokes with low CT ASPECTS, more hemorrhagic transformation, high in-hospital mortality, and poor functional outcome at discharge and 3 months.
Conclusion:
Our study was a hypothesis-generating study with a limited number of patients. This study has reconfirmed the higher severity of the stroke, with a higher mRS score and mortality during the pandemic, especially among COVID-19-positive stroke patients.
Related Concept Videos
01:27Regulation of Stroke Volume
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:22Cardiac Output II: Effect of Stroke Volume on Cardiac Output
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies