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Review
. 2022;51(2):169-177.
doi: 10.1159/000519093. Epub 2021 Sep 30.

Changes in Stroke Patients' Health-Seeking Behavior by COVID-19 Epidemic Regions: Data from the Korean Stroke Registry

Han-Yeong Jeong  1 , Eung-Joon Lee  2 , Min Kyoung Kang  3 , Ki-Woong Nam  2 , Jeonghoon Bae  2 , Kipyoung Jeon  2 , Keun-Hwa Jung  2 , Sang-Bae Ko  2 , Mi Sun Oh  4 , Ji Sung Lee  5 , Jaechun Hwang  6 , Eunhwan Jeong  7 , Jun Lee  8 , Jin-Kuk Do  9 , Sung-Il Sohn  10 , Sun U Kwon  11 , Hee-Joon Bae  12 , Byung-Woo Yoon  2   3 , Jong-Moo Park  3
Affiliations
Review

Changes in Stroke Patients' Health-Seeking Behavior by COVID-19 Epidemic Regions: Data from the Korean Stroke Registry

Han-Yeong Jeong et al. Cerebrovasc Dis. 2022.

Abstract

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has led to changes in stroke patients' healthcare use. This study evaluated changes in Korean stroke patients' health-seeking behaviors and stroke care services using data from the Korean Stroke Registry (KSR).

Methods: We reviewed data from patients with acute stroke and transient ischemic attack (TIA) during 2019 (before COVID-19 period) and 2020 (COVID-19 period). Outcomes included patient characteristics, time from stroke onset to hospital arrival, and in-hospital stroke pathways. Subgroup analyses were performed for an epidemic region (Daegu city and Gyeongsangbuk-do region, the D-G region).

Results: The study included 1,792 patients from the pre-COVID-19 period and 1,555 patients from the COVID-19 period who visited hospitals that contribute to the KSR. During the COVID-19 period, the D-G region had two-thirds the number of cases (vs. the pre-CO-VID-19 period) and a significant decrease in the proportion of patients with TIA (9.97%-2.91%). Unlike other regions, the median onset-to-door time increased significantly in the D-G region (361 min vs. 526.5 min, p = 0.016), and longer onset-to-door times were common for patients with mild symptoms and who were in their 60s or 70s. The number of patients who underwent intravenous thrombolysis also decreased during the COVID-19 period, although the treatment times were not significantly different between the 2 periods.

Discussion/conclusion: Korean stroke patients in a CO-VID-19 epidemic region exhibited distinct changes in health-seeking behaviors. Appropriate triage system and public education regarding the importance of early treatment are needed during the COVID-19 pandemic.

Keywords: Coronavirus disease 2019; Health-seeking behavior; Stroke; Stroke registry; Transient ischemic attack.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Cumulative number of COVID-19 cases in the Daegu and Gyeongsangbuk-do region (per 100,000 persons) between February 18, 2020, and April 31, 2020 (a) and in the Republic of Korea until April 31, 2020 (b).
Fig. 2
Fig. 2
Changes in the median onset-to-door times for stroke patients according to the region.
Fig. 3
Fig. 3
Changes in the median onset-to-door times for stroke patients in the Daegu and Gyeongsangbuk-do region according to the age group (a), sex (a), and National Institutes of Health Stroke Scale score (c).
See this image and copyright information in PMC

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