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2020 ; 29
(8
): 104953
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Falling stroke rates during COVID-19 pandemic at a comprehensive stroke center
#MMPMID32689621
Siegler JE
; Heslin ME
; Thau L
; Smith A
; Jovin TG
J Stroke Cerebrovasc Dis
2020[Aug]; 29
(8
): 104953
PMID32689621
show ga
INTRODUCTION: Although there is evidence to suggest a high rate of
cerebrovascular complications in patients with SARS-CoV-2 infection, anecdotal
reports indicate a falling rate of new ischemic stroke diagnoses. We conducted an
exploratory single-center analysis to estimate the change in number of new stroke
diagnoses in our region, and evaluate the proximate reasons for this change
during the COVID-19 pandemic at a tertiary care center in New Jersey. PATIENTS
AND METHODS: A Comprehensive Stroke Center prospective cohort was retrospectively
analyzed for the number of stroke admissions, demographic features, and
short-term outcomes 5 months prior to 3/1/2020 (pre-COVID-19), and in the 6 weeks
that followed (COVID-19 period). The primary outcome was the number of new acute
stroke diagnoses before and during the COVID-19 period, as well as the potential
reasons for a decline in the number of new diagnoses. RESULTS: Of the 328
included patients, 53 (16%) presented in the COVID-19 period. There was a mean
fall of 38% in new stroke diagnoses (mean 1.13/day [SD 1.07] from 1.82/day [SD
1.38], p<0.01), which was related to a 59% decline in the number of daily
transfers from referral centers (p<0.01), 25% fewer telestroke consultations
(p=0.08), and 55% fewer patients presenting directly to our institution by
private vehicle (p<0.01) and 29% fewer patients through emergency services
(p=0.09). There was no significant change in the monthly number of strokes due to
large vessel occlusion (LVO), however the proportion of new LVOs nearly doubled
in the COVID-19 period (38% vs. 21%, p=0.01). CONCLUSIONS: The observations at
our tertiary care center corroborate anecdotal reports that the number of new
stroke diagnoses is falling, which seems related to a smaller proportion of
patients seeking healthcare services for milder symptoms. These preliminary data
warrant validation in larger, multi-center studies.
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