Abstract
Data about the coronavirus disease 2019 (COVID-19) pandemic’s collateral damage on ischemic stroke (IS) care during the second epidemic wave in Central Europe are limited. We sought to evaluate the impact of the COVID-19 outbreak on Hungarian IS care during the two epidemic waves. This retrospective observational study was based on a nationwide reimbursement database that encompasses all IS admissions and all reperfusion interventions, i.e., intravenous thrombolysis (IVT) and endovascular therapy (EVT) from 2 January 2017 to 31 December 2020 in Hungary. COVID-19 pandemic’s effect on the number of IS admissions and reperfusion interventions were analyzed using different statistics: means, medians, trends, relative rates, and linear relationships. The mean and median values of IS admissions and reperfusion interventions decreased only in some measure during the COVID-periods. However, trend analysis demonstrated a significant decline from the trends. The decline’s dynamic and amplitude have differed for each variable. In contrast to IVT, the number of IS admissions and EVTs negatively correlated with the epidemic waves’ amplitude. Besides, the decrease in the number of IS admissions was more pronounced than the decrease in the number of reperfusion interventions. Our study demonstrated a significant disruption in IS care during the COVID-19 epidemic in Hungary, in which multiple different factors might play a role. The disproportionate reduction of IS admission numbers could partially be explained by the effect of health emergency operative measures and changes in patients’ social behavior. Further studies are needed to evaluate the causes of our observations.
Highlights
Cerebrovascular diseases are the second leading cause of death worldwide
Our database encompasses all admissions for ischemic stroke (IS) and all reperfusion interventions — intravenous thrombolysis (IVT) and endovascular therapy (EVT) — performed by healthcare providers supervised by National Healthcare Service Center of Hungary (NHSC) from 2 January 2017 to 31 December 2020
In contrast to stroke mimics, the following group of patients could be included in the cohort: acute ISs, non-acute ISs, in-hospital ISs, IS chameleons, and incidental asymptomatic cerebral infarcts
Summary
Cerebrovascular diseases are the second leading cause of death worldwide. Up to 50% of stroke survivors are chronically disabled, which causes a tremendous public health burden with severe economic and social consequences [1]. Bereczki Neuroepidemiology Research Group ELKH, MTA-SE, Budapest, Hungary. Banczerowski Department of Neurosurgery, Semmelweis University, Budapest, Hungary
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