Research Article
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Year 2025, Volume: 39 Issue: 2, 137 - 144, 20.05.2025
https://doi.org/10.18614/dehm.1699943

Abstract

References

  • 1. Kumar A, Singh R, Kaur J, Pandey S, Sharma V, Thakur L, et al. Wuhan to World: The COVID-19 Pandemic. Front Cell Infect Microbiol 2021;11.
  • 2. COVID-19 cases | WHO COVID-19 dashboard n.d. Available from:URL: https://data.who.int/dashboards/covid19/cases?n=c (accessed January 15, 2024).
  • 3. Malas MB, Naazie IN, Elsayed N, Mathlouthi A, Marmor R, Clary B. Thromboembolism risk of COVID-19 is high and associated with a higher risk of mortality: A systematic review and meta-analysis. EClinicalMedicine 2020;29–30.
  • 4. Bikdeli B, Madhavan MV, Jimenez D, Chuich T, Dreyfus I, Driggin E, et al. COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up: JACC State-of-the-Art Review. J Am Coll Cardiol 2020;75:2950–2973.
  • 5. 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;191:145–147.
  • 6. Loo J, Spittle DA, Newnham M. COVID-19, immunothrombosis and venous thromboembolism: biological mechanisms. Thorax 2021;76:412–420.
  • 7. Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F, et al. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. New England Journal of Medicine 2020;383:120–128.
  • 8. Zhang J, Tecson KM, McCullough PA. Endothelial dysfunction contributes to COVID-19-associated vascular inflammation and coagulopathy. Rev Cardiovasc Med 2020;21:315–319.
  • 9. Kunutsor SK, Laukkanen JA. Incidence of venous and arterial thromboembolic complications in COVID-19: A systematic review and meta-analysis. Thromb Res 2020;196:27–30.
  • 10. Gąsecka A, Borovac JA, Rui &, Guerreiro A, Giustozzi M, Parker W. Thrombotic Complications in Patients with COVID-19: Pathophysiological Mechanisms, Diagnosis, and Treatment. Cardiovasc Drugs Ther. 2021;35:215-229
  • 11. Al-Ani F, Chehade S, Lazo-Langner A. Thrombosis risk associated with COVID-19 infection. A scoping review. Thromb Res 2020;192:152–160.
  • 12. Abou-Ismail MY, Diamond A, Kapoor S, Arafah Y, Nayak L. The hypercoagulable state in COVID-19: Incidence, pathophysiology, and management. Thromb Res 2020;194:101–115.
  • 13. Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990-2010: Findings from the Global Burden of Disease Study 2010. The Lancet 2014;383:245–255.
  • 14. Feigin VL, Brainin M, Norrving B, Martins S, Sacco RL, Hacke W, et al. World Stroke Organization (WSO): Global Stroke Fact Sheet 2022. International Journal of Stroke 2022;17:18–29.
  • 15. Topcuoglu MA, Ozdemir AO. Acute stroke management in Turkey: Current situation and future projection. Eur Stroke J 2023;8:16–20.

The impact of COVID-19 ischemic stroke in the emergency department

Year 2025, Volume: 39 Issue: 2, 137 - 144, 20.05.2025
https://doi.org/10.18614/dehm.1699943

Abstract

OBJEKTIVE(S)
The aim of this study is to investigate the number and characteristics of ischemic stroke patients admitted to the emergency department before and during the COVID-19 pandemic, to determine the impact of the pandemic on a disease with high mortality and morbidity, and to support the development of preventif strategies.

METHODS
This single-center, retrospective cohort study, included patients diagnosed with ischemic stroke and transient ischemic attack who presented to the emergency department between March 2018 and March 2022. We classified patients into two groups, pre-pandemic and pandemic, each covering a two-year periods. We compared the numbers, admission characteristics and outcomes of the patients.

RESULTS
A total of 1,632 patients were included in the study, including 915 patients in the pre-pandemic period and 717 patients in the pandemic period. During the pandemic period, there was a 21.6% decrease in the number of stroke cases (n:915 vs. n:717). The median National Institutes of Health Stroke Scale at admission was similar (4 vs. 4, p = 0.071). The rate of thrombectomy was higher in the pandemic group (p <0.001). The rate of hospitalization was lower in the pandemic group (p <0.001), but there was no difference in 28-day mortality (p = 0.100).

DISCUSSION
During the COVID-19 pandemic, we observed a decline in the number of strokes, as a result of people in seeking medical care. The implementation of health policies and educational campaigns is essential to ensure timely access to health care and minimize morbidity and mortality in future pandemic.

References

  • 1. Kumar A, Singh R, Kaur J, Pandey S, Sharma V, Thakur L, et al. Wuhan to World: The COVID-19 Pandemic. Front Cell Infect Microbiol 2021;11.
  • 2. COVID-19 cases | WHO COVID-19 dashboard n.d. Available from:URL: https://data.who.int/dashboards/covid19/cases?n=c (accessed January 15, 2024).
  • 3. Malas MB, Naazie IN, Elsayed N, Mathlouthi A, Marmor R, Clary B. Thromboembolism risk of COVID-19 is high and associated with a higher risk of mortality: A systematic review and meta-analysis. EClinicalMedicine 2020;29–30.
  • 4. Bikdeli B, Madhavan MV, Jimenez D, Chuich T, Dreyfus I, Driggin E, et al. COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up: JACC State-of-the-Art Review. J Am Coll Cardiol 2020;75:2950–2973.
  • 5. 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;191:145–147.
  • 6. Loo J, Spittle DA, Newnham M. COVID-19, immunothrombosis and venous thromboembolism: biological mechanisms. Thorax 2021;76:412–420.
  • 7. Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F, et al. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. New England Journal of Medicine 2020;383:120–128.
  • 8. Zhang J, Tecson KM, McCullough PA. Endothelial dysfunction contributes to COVID-19-associated vascular inflammation and coagulopathy. Rev Cardiovasc Med 2020;21:315–319.
  • 9. Kunutsor SK, Laukkanen JA. Incidence of venous and arterial thromboembolic complications in COVID-19: A systematic review and meta-analysis. Thromb Res 2020;196:27–30.
  • 10. Gąsecka A, Borovac JA, Rui &, Guerreiro A, Giustozzi M, Parker W. Thrombotic Complications in Patients with COVID-19: Pathophysiological Mechanisms, Diagnosis, and Treatment. Cardiovasc Drugs Ther. 2021;35:215-229
  • 11. Al-Ani F, Chehade S, Lazo-Langner A. Thrombosis risk associated with COVID-19 infection. A scoping review. Thromb Res 2020;192:152–160.
  • 12. Abou-Ismail MY, Diamond A, Kapoor S, Arafah Y, Nayak L. The hypercoagulable state in COVID-19: Incidence, pathophysiology, and management. Thromb Res 2020;194:101–115.
  • 13. Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990-2010: Findings from the Global Burden of Disease Study 2010. The Lancet 2014;383:245–255.
  • 14. Feigin VL, Brainin M, Norrving B, Martins S, Sacco RL, Hacke W, et al. World Stroke Organization (WSO): Global Stroke Fact Sheet 2022. International Journal of Stroke 2022;17:18–29.
  • 15. Topcuoglu MA, Ozdemir AO. Acute stroke management in Turkey: Current situation and future projection. Eur Stroke J 2023;8:16–20.
There are 15 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section research article
Authors

Ertuğ Orhan 0000-0001-8982-0096

Publication Date May 20, 2025
Submission Date February 28, 2025
Acceptance Date April 22, 2025
Published in Issue Year 2025 Volume: 39 Issue: 2

Cite

Vancouver Orhan E. The impact of COVID-19 ischemic stroke in the emergency department. Dev Exp Health Med. 2025;39(2):137-44.