1842-PUB: Ischemic Stroke in Patients with Diabetes Mellitus during COVID-19 Pandemic in South Korea, Using National Emergency Department Information System

Abstract

Background: Coronavirus disease 2019 (COVID-19) put strain on patients using health care services, which results in suboptimal care for diseases requiring prompt management, such as ischemic stroke. Patients with diabetes mellitus (DM), high risk group of stroke, were compromised with routine diabetic care during pandemic. Until now, the influence of this outbreak on the management of ischemic stroke has not been clarified both in total and DM subjects. Methods: This nationwide population-based study analyzed 11,734 patients diagnosed of acute ischemic stroke and underwent intravenous thrombolysis (IVT) or endovascular thrombectomy (EVT) during January 2019 (reference year) to December 2020 (pandemic year). The changes in the frequency of ED visit, treatment modality and outcomes by ischemic stroke were compared between pandemic and reference period. Subgroup analysis in DM patients was also performed. Results: During COVID-19 pandemic, incidence of ischemic stroke available requiring for urgent procedures increased by 7.57% in South Korea (5,653 in 2019 vs 6,081 in 2020). In total subjects, time for symptom onset to ED visit and for ED visit to admission was significantly delayed. As a treatment modality, the rate of IVT increased, while that of patients applied mechanical ventilation decreased. Especially, DM patients aged more than seventies exhibited a significant higher chance to ICU admission rate during pandemic (p-value < 0.01). Nevertheless, there was no significant difference in hospital-stay days and in-hospital mortality both in total and DM subjects. Conclusion: During COVID-19 pandemic, the incidence of ischemic stroke necessary for emergency care was increased and elderly DM patient showed a higher ICU admission rate. However, overall treatment outcome of ischemic stroke was preserved during this outbreak period in South Korea. Disclosure M.Park: None. S.Jang: None. K.Choi: None. S.Baik: None. H.Yoo: None.