Abstract
Background: The COVID-19 pandemic might affect health care resources and alter patient admission to hospital in case of stroke or transient ischemic attack (TIA). We aim to determine whether the COVID-19 pandemic is affecting utilization of recanalization procedures and numbers of patients with stroke and TIA admitted to a primary care stroke center.Methods: In this retrospective observational study, we compared patients admitted from January 2019 until February 2020 with patients admitted during the COVID-19 pandemic (March/April 2020) in Germany. We included patients with stroke (hemorrhagic or ischemic) or TIA as classified by International Statistical Classification of Diseases and Related Health Problems version 10 (ICD-10).Results: The number of patients per month with ischemic stroke or TIA was found to have significantly decreased from January 2019 until February 2020 compared to the COVID-19 pandemic (March/April 2020) (ischemic stroke 69.1 ± 4.5 vs. 55 ± 5.7, p < 0.001, TIA 22.1 ± 4.1 vs. 14.5 ± 6.4, p < 0.034). Contrarily, percentages and numbers of recanalization procedures per month were not influenced by the COVID-19 pandemic (intravenous thrombolysis [iv-tPA] 9.4 ± 3.7 vs. 10.5 ± 0.5, p = 0.697, mechanical thrombectomy [MT] 13.1 ± 3.1 vs. 14.5 ± 3.5, p = 0.580, iv-TPA or MT 19.4 ± 4.1 vs. 19.0 ± 0.0, p = 0.889).Conclusions: During the COVID-19 pandemic, resources of the healthcare system in a primary care university hospital in Germany still allowed for unchanged numbers of recanalization procedures due to ischemic stroke. However, the numbers of patients admitted to the hospital specifically due to ischemic stroke or TIA decreased, suggesting that the awareness for non-disabling stroke symptoms has to be increased.
Highlights
On March 11, 2020, the Corona Virus Disease 2019 (COVID19) was declared a global pandemic by the World Health Organization [1]
In March/April 2020, there was a decrease in patients admitted due to ischemic/hemorrhagic stroke or transient ischemic attack (TIA) (74 ± 12.7) as compared to the preceding 14 months with an average of 95.9 ± 6.3 patients per month (p < 0.001)
In order to get an impression of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) situation in the location of the center examined within this report, we compared the incidence of confirmed SARS-CoV-2 cases in Mainz with other urban areas and Germany as a whole
Summary
On March 11, 2020, the Corona Virus Disease 2019 (COVID19) was declared a global pandemic by the World Health Organization [1]. The organizational structure of hospitals changed in order to be prepared for an increased admission of COVID-19 patients by reducing non-emergency ambulatory patients and elective hospital admissions. These circumstances led to the question of what happens with other severe disease such as stroke, especially considering reports from Italian colleagues depicting almost a disappearance of patients with ischemic strokes within their hospitals [3] and similar reports from North America [4, 5] and Brazil [6]. We aim to elucidate whether the COVID-19 pandemic affected either the admission of patients to our primary care stroke center or the rates of stroke recanalization therapies. We aim to determine whether the COVID-19 pandemic is affecting utilization of recanalization procedures and numbers of patients with stroke and TIA admitted to a primary care stroke center
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