Impact of a Stay-at-Home Order on Stroke Admission, Subtype, and Metrics during the COVID-19 Pandemic.
Age Factors
Aged
COVID-19
/ epidemiology
Cerebrovascular Disorders
/ complications
Communicable Disease Control
/ methods
Female
Humans
Male
Patient Admission
/ trends
SARS-CoV-2
Social Isolation
Stroke
/ classification
Thrombectomy
/ methods
Thrombolytic Therapy
/ methods
United States
/ epidemiology
COVID-19
Stay-at-home order
Stroke admission and subtype
Stroke metrics
Journal
Cerebrovascular diseases extra
ISSN: 1664-5456
Titre abrégé: Cerebrovasc Dis Extra
Pays: Switzerland
ID NLM: 101577885
Informations de publication
Date de publication:
2020
2020
Historique:
received:
16
09
2020
accepted:
01
11
2020
pubmed:
10
11
2020
medline:
5
1
2021
entrez:
9
11
2020
Statut:
ppublish
Résumé
Our study aims to evaluate the impact of a stay-at-home order on stroke metrics during the 2019-novel coronavirus (COVID-19) pandemic. Data on baseline characteristics, stroke subtype, initial National Institutes of Health Stroke Scale (NIHSS) score, the time between last known well (LKW) to emergency department (ED) arrival, tissue plasminogen activator (tPA) administration, the involvement of large vessel occlusion (LVO), and whether mechanical thrombectomy (MT) was pursued in patients with acute stroke were extracted from 24 March to 23 April 2020 (the time period of a stay-at-home order was placed due to the COVID-19 pandemic as the study group) at a tertiary care hospital in West Michigan, USA, compared with data from 24 March to 23 April 2019 (control group). Our study demonstrated a reduction in cases of acute ischemic stroke (AIS), although this did not reach statistical significance. However, there was an increase in hemorrhagic stroke (7.5% controls vs. 19.2% study group). The age of stroke patients was significantly younger during the period of the stay-at-home order compared to the control group. We identified a significant overall delay of ED arrivals from LKW in the study group. Additionally, an increased number of AIS patients with LVO in the study group (34.8%) was found compared to the control group (17.5%). A significantly increased number of patients received MT in the study group. Additionally, 11 patients were COVID-19 PCR-positive in the study group, 10 with AIS and only 1 with hemorrhagic stroke. Patients with COVID-19 had a high incidence of atrial fibrillation and hyperlipidemia. One AIS patient with COVID-19 rapidly developed cytotoxic edema with corresponding elevated inflammatory biomarkers. No statistical significance was noted when stroke subtype, LVO, and MT groups were compared. There was a trend of decreasing AIS admissions during the COVID-19 pandemic. There was also a significantly increased number of AIS patients with LVO who received MT, especially those with COVID-19. We conclude that cytokine storm resulting from SARS-CoV-2 infection might play a role in AIS patients with COVID-19.
Identifiants
pubmed: 33166950
pii: 000512742
doi: 10.1159/000512742
pmc: PMC7705941
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
159-165Informations de copyright
© 2020 The Author(s) Published by S. Karger AG, Basel.
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