Abstract
(1) Background: The impact of the health crisis caused by coronavirus disease 2019 (COVID-19) has provoked collateral effects in the attention to pathologies with time-dependent treatments such as strokes. We compare the healthcare activity of two stroke units in the same periods of 2019 and 2020, with an emphasis on what happened during the state of alarm (SA). (2) Materials and methods. Hospitals in the region implemented contingency plans to contain the pandemic; in this planning, the stroke units were not limited in their operational capacity. The SA was declared on 15 March and remained in place for 10 weeks. For the analysis, the data were grouped by consecutive calendar weeks. (3) Results. When the SA was declared the number of calls to the emergency telephone went from 1225 to 3908 calls per week (318% increase). However, the activation of the stroke code went from 6.6 to 5.0 (p = 0.04) and the activity in both stroke units decreased. The largest drop in hospitalizations was for transient ischemic attacks (TIAs) with 35.7% less, 28 vs. 18, (p = 0.05). Reperfusion therapies fell by 37.5%; Poisson regression model 0.64; (95% confidence interval (CI), 0.43–0.95). The overall activity of the telestroke suffered a reduction of 28.9%. We also observed an increase in hospital mortality. (4) Conclusion. The excessive duration of the pandemic precludes any hope of resolving this public health crisis in the short or medium term. Further studies should be conducted to better understand the multifactorial nature of this dramatic decline in stroke admissions and its negative impact.
Highlights
Health System and Stroke Organization In Extremadura, acute stroke care is provided through a network consisting of a stroke center, a stroke unit and 9 hospitals connected by telestroke
The Hospital Universitario de Badajoz (HUB) is a public university hospital with 915 hospital beds, including 30 intensive-care beds, which serves as a community hospital for a population of 271,885 inhabitants and provides tertiary stroke care to a population of 676,376 inhabitants
The results presented in this panel are obtained from the declaration of COVID-19 cases to the National Network of Epidemiological Surveillance (RENAVE) through the Surveillance System in Spain (SIVIES) web computing platform managed by the National
Summary
In December 2019, the first identified cases of a new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in Wuhan, China, was followed a pandemic with cases reported in more than 200 countries [1]. The crisis is so severe that it could overwhelm the health care system in many countries [2], and depending on the local intensity of the epidemic, there is a high risk of not applying well-established therapies to patients with prevalent conditions such as cancer, acute myocardial infarction, or acute ischemic stroke [3,4,5]. How efficient the overall system of care is in providing optimized prehospital triage and equitable access to acute treatment in hospitals will undoubtedly be key [5,7]
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