Abstract
We reviewed stroke care delivery during the COVID-19 pandemic at our stroke center and provincial telestroke system. We counted referrals to our prevention clinic, code strokes, thrombolysis, endovascular thrombectomies, and activations of a provincial telestroke system from February to April of 2017-2020. In April 2020, there was 28% reduction in prevention clinic referrals, 32% reduction in code strokes, and 26% reduction in telestroke activations compared to prior years. Thrombolysis and endovascular thrombectomy rates remained constant. Fewer patients received stroke services across the spectrum from prevention, acute care to telestroke care in Ontario, Canada, during the COVID-19 pandemic.
Highlights
RÉSUMÉ : Diminution du nombre de patients victimes d’un AVC s’étant présentés dans un centre de soins complets au cours de la pandémie de COVID-19
Reports from several comprehensive stroke centers have suggested a decline in patient presentations to stroke prevention clinics and to acute stroke services since the initiation of lockdowns during the COVID-19 pandemic.[1,2]
Fears of exposure to infection are less likely to prevent patients with severe stroke to present for thrombolysis or endovascular thrombectomy (EVT)
Summary
“shutdown.” We hypothesized that referrals to stroke prevention clinic, code stroke activations, and telestroke activations have declined during the pandemic shutdown. A similar pattern is seen across our provincial telestroke system which had a 25.5% drop in activations in April 2020 compared to the same month in 2017–2019 These findings are consistent with those recently reported by two North American comprehensive stroke centers.[1,2]. We emphasize the importance and impact of acute stroke care and stroke prevention, in particular given our finding that the administration of tPA and EVT has not dropped This suggests that severe strokes are still happening, and it is perhaps patients with milder presentations who are avoiding activation of emergency systems. This is of concern as minor strokes and TIAs are Volume 48, No 1 – January 2021
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