Abstract
Objectives: Thousands of designated COVID-19 hospitals have been set up in China to fight the ongoing COVID-19 pandemic. Anecdotal reports indicate a falling rate of acute stroke diagnoses in these hospitals during the COVID-19 period. We conducted an exploratory single-center analysis to estimate the change in acute stroke presentation at the designated COVID-19 hospitals.Methods: This retrospective observational study included all patients admitted to Yongchuan Hospital Affiliated to Chongqing Medical University with acute stroke between January 24 and March 10, 2020. Patient demographics, characteristics of the stroke, treatment details, and clinical outcomes were compared with those of patients admitted in the corresponding period in the year before (2019, “the pre-COVID-19 period”). Subgroup analysis was performed in the ischemic and hemorrhagic stroke groups.Results: A total of 110 patients presented with acute stroke symptoms during the COVID-19 pandemic, compared with 173 patients in the pre-COVID-19 period. A higher proportion of stroke patients presented to the hospital via emergency medical services during the pandemic (48.2 vs. 31.8%, p = 0.006). There was a lower proportion of ischemic stroke patients (50.9 vs. 65.3%, p = 0.016) than in the preceding year. There were significantly fewer patients with 90-day modified Rankin Scale score ≥3 in the COVID-19 period compared with the pre-COVID-19 period (17.3 vs. 30.6%, p = 0.012). Among patients with ischemic stroke, the mean time from patient arrival to vessel puncture for emergency endovascular therapy in the COVID-19 period was shorter than that in the pre-COVID-19 period (109.18 ± 71.39 vs. 270.50 ± 161.51 min, p = 0.002). Among patients with hemorrhagic stroke, the rate of emergency surgical operation in the COVID-19 period was higher than that in the pre-COVID-19 period (48.1 vs. 30.0%, p = 0.047). The mean time from patient arrival to emergency surgical operation (15.31 ± 22.89 vs. 51.72 ± 40.47 min, p = 0.002) was shorter in the COVID-19 period than in the pre-COVID-19 period.Conclusions: Although fewer acute stroke patients sought medical care in this designated COVID-19 hospital during the COVID-19 pandemic, this type of hospital was more efficient for timely treatment of acute stroke. Recognizing how acute strokes presented in designated COVID-19 hospitals will contribute to appropriate adjustments in strategy for dealing with acute stroke during COVID-19 and future pandemics.
Highlights
The COVID-19 pandemic, which originated in Wuhan, China, in December of 2019, spread rapidly worldwide and became a huge challenge for global health systems
Acute stroke can be divided into ischemic stroke and hemorrhagic stroke according to the occurrence of cerebrovascular blockage and cerebrovascular rupture, which is usually verified by imaging examination [2, 3]
The COVID-19 pandemic has had a huge impact on our hospital, especially in the early stages of the pandemic, when the hospital served as a designated COVID-19 hospital
Summary
The COVID-19 pandemic, which originated in Wuhan, China, in December of 2019, spread rapidly worldwide and became a huge challenge for global health systems. By December 31, 2020, the global number of COVID-19 infections and related deaths had reached over 83 million and 1.8 million, respectively [1]. Acute stroke refers to a sudden cerebrovascular accident and is a medical emergency. Thrombolytic therapy, endovascular therapy, and surgery within the time window have a significant impact on the prognosis of acute stroke patients [4,5,6]. Reports suggest that the number of acute stroke patients presenting to hospitals during COVID-19 was significantly reduced [7]
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