Acute Stroke Care during COVID-19: National Data

Abstract

(1) Background: The pandemic of COVID-19 and subsequent lockdown strategies had a profound impact on many aspects of everyday life. During this time the world faced the unprecedented crisis of healthcare disrupting timely care delivery. This study was designed to evaluate the impact of the pandemic on the acute treatment of stroke in Poland. (2) Methods: The national data on hospitalizations with stroke as a primary diagnosis were obtained from the National Health Fund of Poland. Poisson regression was used to determine the significance of the change in hospital admissions. The differences between proportions were analyzed using the "N-1" Chi-squared test. (3) Results: During the COVID-19 period, the number of hospitalizations dropped by 8.28% with a monthly nadir of 22.02 in April. On a monthly scale during 2020, the greatest decrease was 22.02%. The thrombolysis ratio was also affected, with the highest monthly drop of 15.51% in November. The overall number of in-hospital deaths did not change. (4) Conclusions: The pandemic caused a serious disruption of the acute care of stroke. There is no evidence that the quality of care was seriously compromised.

Keywords: COVID-19; acute stroke; pandemic.

Figure 1

The timeline of the COVID-19 pandemic. (a) all stroke hospitalizations, (b) hospitalizations w/thrombolysis, (c) hospitalizations w/mechanical thrombectomy. Solid line2019, dotted line—2020, grey bars—new COVID-19 cases, arr↓—the movement restrictions introduced, ↑—the movement restriction lifted. * p < 0.0001.