Abstract
BackgroundThere was a significant decrease in stroke admissions during the first phase of the COVID-19 pandemic. There are concerns that stroke patients have not sought medical attention and in the months after the lockdown suffer recurrent severe strokes. The aims of this study were to investigate how stroke admission rates and distributions of severity varied before, during and after the lockdown in a representative Norwegian hospital population.MethodsAll patients discharged from Akershus University Hospital with a diagnosis of transient ischemic attack (TIA) or acute stroke from January to September 2020 were identified by hospital chart review.ResultsWe observed a transient decrease in weekly stroke admissions during lockdown from an average of 21.4 (SD 4.7) before to 15.0 (SD 4.2) during and 17.2 (SD 3.3) after (p < 0.011). The proportion of mild ischemic and haemorrhagic strokes was also lower during lockdown with 66% before, 57% during and 68% after (p = 0.011).ConclusionThe period of COVID-19 lockdown was associated with a temporary reduction in total admissions of strokes. In particular, there were fewer with TIA and mild stroke. Given the need to prevent the worsening of symptoms and risk of recurrence, it is necessary to emphasise the importance to seek medical care even in states of emergency.
Highlights
Many stroke centres have reported that COVID-19 discourages patients from contacting the health care system with an increase in prehospital delay and decrease in stroke admissions as a result [1,2,3,4,5,6,7,8,9,10,11,12,13,14]
Given that the number of mild strokes in the population was unchanged during the pandemic, a large number of these patients did not seek medical attention
Patients with mild strokes are at risk of recurrent and more severe strokes without urgent treatment and initiation of secondary prevention [15, 16]
Summary
Many stroke centres have reported that COVID-19 discourages patients from contacting the health care system with an increase in prehospital delay and decrease in stroke admissions as a result [1,2,3,4,5,6,7,8,9,10,11,12,13,14]. People with mild strokes not admitted during the pandemic are possibly at increased risk of future recurrent strokes, dependency or death. There have been some anecdotal and mass media reports that the number of stroke patients seen in the emergency department has increased and that a larger proportion than usual have severe strokes. The aims of this study were to investigate how stroke admission rates and distributions of severity varied before, during and after the lockdown in a representative Norwegian hospital population
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