Abstract P846: The Collateral Damage of COVID-19 Pandemic on Stroke Care: Data From a State Stroke Registry

Abstract

Introduction: During the Coronavirus Disease-2019 (COVID-19) pandemic the “stay-home” public campaign implemented to contain the spread of the virus and the reorganization of hospitals to manage the overwhelming volume of affected patients, may have had unintended consequences. Prior studies reported a decrease in the number of stroke and TIAs admissions. Most reports have been from single hospitals, there is no data available on the impact on a statewide level. Methods: A retrospective analysis of stroke quality improvement data reported to the State of Maryland. These data are from Primary, Thrombectomy-Capable, and Comprehensive Stroke Centers. The number of admissions for stroke overall and by stroke subtype are reported and compared for March-June 2020 vs. March-June 2019. Last known well (LKW) to hospital arrival, intravenous tPA (IV tPA) and thrombectomy rates were analyzed. Results: The overall number of stroke admissions from March-June 2020 compared to March-June 2019 was 1,001 vs. 1,203 in March, 809 vs. 1,112 in April, 950 vs. 1206 in May, and 937 vs. 1,261 in June. There was an average 21% decrease for the 4-month period in 2020 compared to 2019. For ischemic stroke, there was a decrease in hospital admission for each month in 2020 vs. 2019: 740 vs. 922 in March, 606 vs. 866 in April, 721 vs. 906 in May, and 698 vs. 880 in June. TIAs admission rates were similarly decreased in 2020 vs. 2019: 116 vs. 136, 74 vs. 97, 111 vs. 137, and 107 vs. 111. The number of ICH admissions in 2020 vs. 2019 was 100 vs. 107 in March, 90 vs. 112 in April, 96 vs. 116 in May, and 103 vs. 121 in June. Median LKW well to hospital arrival was 292 vs. 254 min in March, 383 vs. 293 min in April, 291.5 vs. 247 min in May, and 320 vs. 292 min in June. There was about 1% decrease in thrombectomy rates in the 4-month period in 2020 compared to 2019. Conclusions: During the COVID-19 pandemic in the State of Maryland there was a consistent decrease in the volume of stroke admissions. Median LKW to hospital arrival was also increased, supporting evidence for of a delay in stroke care. While reasons for these changes need to be further explored, our findings suggest that public health campaigns for the pandemic should take into account and not adversely affect the acute care of unrelated medical emergencies.