Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2020 Aug;29(8):104988.
doi: 10.1016/j.jstrokecerebrovasdis.2020.104988. Epub 2020 Jun 10.

Collateral damage - Impact of a pandemic on stroke emergency services

Shashvat M Desai  1 , Francis X Guyette  2 , Christian Martin-Gill  3 , Ashutosh P Jadhav  4
Affiliations
Comparative Study

Collateral damage - Impact of a pandemic on stroke emergency services

Shashvat M Desai et al. J Stroke Cerebrovasc Dis. 2020 Aug.

Abstract

Background: The COVID-19 pandemic's impact on stroke care is two-fold direct impact of the infection and indirect impact on non-COVID-19 diseases. Anecdotal evidence and clinical observation suggest that there is a decrease in the number of patients presenting with stroke during the pandemic. We aim to understand the impact of the COVID-19 pandemic on the utilization of stroke emergency services on a single comprehensive stroke center (CSC).

Methods: We performed a retrospective analysis of a prospectively maintained database and compared all emergency department (ED) encounters, acute stroke admissions (including TIA), and thrombectomy cases admitted in March 2017-2019 to patients admitted in March 2020 at a comprehensive stroke center.

Results: Number of total ED encounters (22%, p=0.005), acute ischemic strokes (40%, p=0.001), and TIAs (60%, p=0.163) decreased between March of 2017-2019 compared to March of 2020. The number of patients undergoing EVT in March 2020 was comparable to March 2017-2019 (p=0.430).

Conclusion: A pandemic-related stay-at-home policy reduces the utilization of stroke emergency services at a CSC. This effect appears to be more prominent for ED encounters, all stroke admissions and TIAs, and less impactful for severe strokes. Given the relatively low prevalence of COVID-19 cases in our region, this decrement is likely related to healthcare seeking behavior rather than capacity saturation.

Keywords: Covid; Epidemiology; Stroke; TIA; thrombectomy.

PubMed Disclaimer

Figures

Fig 1
Fig. 1
Interaction between various entities during the COVID-19 pandemic.
Fig 2
Fig. 2
Study design flowchart.
Fig 3
Fig. 3
Stroke/TIA admissions across March of 2017–2020.
See this image and copyright information in PMC

References

    1. Hughes HE, Colón-González FJ, Fouillet A. The influence of a major sporting event upon emergency department attendances; a retrospective cross-national European study. PLOS ONE. 2018;13 - PMC - PubMed
    1. Jena AB, Mann NC, Wedlund LN, Olenski A. Delays in emergency care and mortality during major U.S. marathons. N Engl J Med. 2017;376:1441–1450. - PMC - PubMed
    1. Coronavirus Disease (COVID-19) - events as they happen. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-a...(accessed May 11, 2020).
    1. Krumholz HM., M.D. The New York Times; 2020. Where have all the heart attacks gone?https://www.nytimes.com/2020/04/06/well/live/coronavirus-doctors-hospita... published online April 6.
    1. Kennedy K.Cleveland clinic says ER visits for heart attack and stroke patients are down 40% because of COVID-19 fears. https://www.cleveland19.com. https://www.cleveland19.com/2020/04/17/cleveland-clinic-says-er-visits-h... (accessed April 18, 2020).

Publication types

MeSH terms