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Multicenter Study
. 2022 May;31(5):106405.
doi: 10.1016/j.jstrokecerebrovasdis.2022.106405. Epub 2022 Feb 21.

Social Distancing, Stroke Admissions and Stroke Mortality During the COVID-19 Pandemic: A Multicenter, Longitudinal Study

Pedro Cougo  1 , Bruno Besen  2 , Daniel Bezerra  3 , Rodrigo de Carvalho Moreira  4 , Carlos Eduardo Brandão  5 , Emmanuel Salgueiro  6 , Alex Balduino  4 , Octávio Pontes-Neto  7 , Victor Cravo  6
Affiliations
Multicenter Study

Social Distancing, Stroke Admissions and Stroke Mortality During the COVID-19 Pandemic: A Multicenter, Longitudinal Study

Pedro Cougo et al. J Stroke Cerebrovasc Dis. 2022 May.

Abstract

Objectives: We aimed to evaluate the relationship between social distancing, stroke admissions and stroke mortality during the COVID-19 pandemic, while accounting for the rate of COVID-19 admissions.

Methods: We performed a longitudinal analysis of a multicenter, prospective, hospital-based registry of intensive care units from 19 hospitals from Brazil, comprising a 14-month period of the COVID-19 pandemic. We investigated whether the daily rate of admissions (DRAstroke) and daily mortality rate for stroke were associated with the social distancing index (SDI), taking into account the daily rate of admissions for COVID-19 (DRACOVID) in univariate and multivariate regression models. We also compared the clinical characteristics of patients with stroke admitted before and during the pandemic.

Results: We found that DRAstroke decreased significantly in association with a strong rise in the SDI during the early months of the pandemic. However, in the latter period of the pandemic, only minor changes were observed in the SDI, and still, DRAstroke was inversely associated with the DRACOVID. Throughout the pandemic, higher SDI and DRACOVID were associated with higher in-hospital mortality for stroke.

Conclusions: The severity of surges of the COVID-19 pandemic were independently and persistently associated with declines in stroke admissions, even during periods when social distancing policies were not intensified.

Keywords: Acute stroke; COVID-19; Epidemiology; Systems of care.

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Conflict of interest statement

Declaration of interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig 1
Fig. 1
Title. Daily rate (light line) and 14-day moving average (bold line) of COVID-19 admissions, stroke admissions, stroke mortality rate, and social distancing index (SDI) from 2019 throughout the pandemic period.
Fig 2
Fig. 2
Social distancing indexes in the nine cities included in the registry.
See this image and copyright information in PMC

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