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

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.

Keywords

• COVID-19
• Emergency Department
• ischemic stroke
• thrombectomy

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