Elsevier

Journal of Critical Care

Volume 62, April 2021, Pages 230-234
Journal of Critical Care

The effect of the COVID-19 pandemic on ED referrals and care for stroke patients: A four-year comparative study

https://doi.org/10.1016/j.jcrc.2020.12.011Get rights and content

Highlights

  • Anecdotal reports on patients avoiding urgent care duringthe COVID-19 pandemic, have been increasingly documented.

  • A 41% decrease was noted during January-April 2020 in the number of patients admitted with suspected AIS, compared with 2019.

  • We found an increase of proportion of patients arriving within 6 h of symptoms onset compared with previous years.

Abstract

Purpose

To examine the impact of the COVID-19 pandemic on the presentation and care provided to patients with acute ischemic stroke (AIS) at the emergency department (ED).

Method

A retrospective-archive study was conducted between January-April 2020, compared with the parallel months in 2017–2019, in a comprehensive stroke center. We compared the time from symptoms onset to ED arrival, the number of neurologic consultations completed in the ED, patients diagnosed with AIS, patients receiving acute treatment and hospital mortality.

Results

During January-April 2020, we found an increase in the proportion of stroke patients arriving at the ED within 6 h of symptom onset: 68–100% per month during the study period, compared with 28–42% per month in the previous years. The number of patients admitted to the ED with suspected AIS declined by 41%, compared to the parallel period in 2019. An increase was noted in the number of patients diagnosed with AIS who underwent treatment, with the number of s endovascular thrombectomy increasing throughout the examined year.

Conclusion

During the COVID-19 pandemic, we observed a significant decline in the number of AIS patients admitted to the ED. Paradoxically, we have seen an increase in the proportion of patients who arrived shortly after the onset of symptoms and received timely treatment. Future studies might investigate the medical mechanism and ramifications of this phenomenon.

Keywords

Acute ischemic stroke
COVID-19
Critical care
Emergency department
In-hospital mortality

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1

Authors contributed equally to this manuscript.

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