Rates of Cranial Computed Tomography before and during the COVID-19 Restrictions in Turkey

Year 2021, Volume: 26 Issue: 3, 282 - 286, 27.09.2021

Başak Atalay Nesrin Gündüz Murat Aşık

https://doi.org/10.21673/anadoluklin.909018

Abstract

Aim: In this study, we aimed to compare the admission and examination data of patients who presented to our emergency department with neurological symptoms in April 2019 (before) and April 2020 (during the COVID-19 pandemic).
Methods: The study included patients who underwent cranial computed tomography (CT), including patients who additionally underwent CT angiography for suspected stroke. Thus, the study sample consisted of a total of 960 patients, of whom 676 (Group) presented before the COVID-19 pandemic and 284 (Group II) during the course of the pandemic. The data were reviewed retrospectively.
Results: The rates of the indications for cranial CT did not statistically significantly (p=0.143) differ between Group I and II: suspected stroke, 76.2% vs. 72.9%; trauma, 22.5% vs. 23.6%; and tumors 1.3% vs. 3.5%, respectively. The rate of finding vessel obstruction on CT angiography was significantly (p<0.05) higher in Group II (25% vs. 65%). The rate of confirmed cases of stroke was significantly (p<0.001) higher in Group II (6.7% vs. 18.7%). Also, the rates of ischemic and hemorrhagic stroke were both significantly higher in Group II (p<0.001 and p=0.043, respectively).
Conclusion: While measures for the prevention of the spread of COVID-19 infection have led to a decrease in hospital admissions, a conspicuous increase was observed in the rate of patients with stroke during the same period of time.

Keywords

Computed tomography, Coronavirus, COVID-19 pandemic

Türkiye’de COVID-19 Kısıtlamaları Sırasındaki ve Öncesindeki Kraniyal Bilgisayarlı Tomografi Oranları

Abstract

Amaç: Bu çalışmada, Nisan 2019 ve Nisan 2020 aylarında (COVID-19 pandemisi öncesinde ve sırasında) nörolojik semptomlarla acil servisimize başvuran hastaların başvuru ve muayene verilerini karşılaştırmak amaçlanmıştır.
Yöntem: Çalışmamız, inme şüphesi nedeniyle ayrıca bilgisayarlı tomografik anjiyografi yapılanlar dahil, acil servisimize başvuran ve kraniyal bilgisayarlı tomografi (BT) çekilen hastalarla gerçekleştirildi. Böylece çalışma örneklemi 676’si (Grup I) COVID-19 pandemisinden önce, 284’ü (Grup II) COVID-19 döneminde başvuran hastalar olmak üzere, toplam 960 hasta içerdi. Veriler retrospektif olarak incelendi.
Bulgular: Grup I ve II arasında kraniyal BT endikasyon oranları bakımından istatistiksel olarak anlamlı (p=0,143) fark görülmedi: inme şüphesi, (sırasıyla) %76,2’e karşı %72,9; travma, %22,5’e karşı %23,6; tümör, %1,3’e karşı %3,5. BT anjiyografide vasküler oklüzyon saptama oranı Grup II’de anlamlı biçimde (p<0,05) daha yüksekti (%25’e karşı %65). Teyit edilmiş inme vakalarının oranı Grup II’de anlamlı biçimde (p<0,001) daha yüksekti (%6,7’ye karşı %18,7). Ayrıca, hem iskemik hem hemorajik inme oranı yine Grup II’de anlamlı biçimde daha yüksekti (sırasıyla p<0,001 ve p=0,043).
Sonuç: COVID-19 enfeksiyonunun yayılımını önlemek için alınan önlemler hastane başvurularında azalmaya neden olurken, aynı dönemdeki inme oranlarında belirgin bir artış gözlenmiştir.

Keywords

Bilgisayarlı Tomografi, COVID-19 pandemisi, Koronavirüs

References

• Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727–33.
• Dawei Wang, Bo Hu, Chang Hu, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061–9.
• Zhu L, She ZG, Cheng X, Qin JJ, Zhang XJ, Cai J, et al. Association of blood glucose control and outcomes in patients with COVID-19 and pre-existing type 2 diabetes. Cell Metab. 2020;31(6):1068–77.
• Ağalar C, Öztürk Engin D. Protective measures for COVID-19 for healthcare providers and laboratory personnel. Turk J Med Sci. 2020;50(SI–1):578–84.
• Sezgin M, Ekizoğlu E, Yeşilot N, Çoban O. Stroke during COVID-19 pandemic. Noro Psikiyatr Ars. 2020;57(2):83–4.
• Hoyer C, Ebert A, Huttner HB, Puetz V, Kallmünzer B, Barlinn K, et al. Acute stroke in times of the COVID-19 pandemic: a multicenter study. Stroke. 2020;51(7):2224–7.
• Tsivgoulis G, Katsanos AH, Ornello R, Sacco S. Ischemic stroke epidemiology during the COVID-19 pandemic: navigating uncharted waters with changing tides. Stroke. 2020;51(7):1924–6.
• Siegler JE, Heslin ME, Thau L, Smith A, Jovin TG. Falling stroke rates during COVID-19 pandemic at a comprehensive stroke center. J Stroke Cerebrovasc Dis. 2020;29(8):104953.
• Pop R, Quenardelle V, Hasiu A, Mihoc D, Sellal F, Dugay MH, et al. Impact of the COVID-19 outbreak on acute stroke pathways insights from the Alsace region in France. Eur J Neurol. 2020;27(9):1783–7.
• Bersano A, Pantoni L. On being a neurologist in Italy at the time of the COVID-19 outbreak. Neurology. 2020;94(21):905–6.
• Caproni S, Di Schino C, Costantini F, Parisi G, Colosimo C. Letter to the editor: COVID-19 does not reduce stroke-related emergencies. Acta Neurol Belg. 2020;120(5):1259–60.
• Altschul DJ, Haranhalli N, Esenwa C, Unda SR, Ramos RG, Dardick J, et al. The impact of COVID-19 on emergent large-vessel occlusion: delayed presentation confirmed by ASPECTS. AJNR Am J Neuroradiol. 2020;41(12):2271–3.
• Dhand A, Luke D, Lang C, Tsiaklides M, Feske S, Lee JM. Social networks and risk of delayed hospital arrival after acute stroke. Nat Commun. 2019;10(1):1206.
• Klok FA, Kruip MJHA, van der Meer NJM, Arbous MS, Gommers DAMPJ, Kant KM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020;191:145–7.
• Sharifi-Razavi A, Karimi N, Rouhani N. COVID-19 and intracerebral haemorrhage: causative or coincidental? New Microbes New Infect. 2020;35:100669.