AUTHOR=Tan Qing , Liu Qing-Jun , Fan Wen-Hui , Du Xiao-Yan , Wu Lin , Gong Hong-Min , Wei Jing , Zhao Rui , Lei Ming , Zhao Li-Bo 

TITLE=Impact of COVID-19 on Acute Stroke Presentation in a Designated COVID-19 Hospital

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.673703

DOI=10.3389/fneur.2021.673703

ISSN=1664-2295

ABSTRACT=Abstract
Objectives: Thousands of designated COVID-19 hospitals have been set up in China to fight the on-going COVID-19 pandemic. Anecdotal reports indicate a falling rate of acute stroke diagnoses in these hospitals during the COVID-19 period. We conducted an exploratory single-center analysis to estimate the change in acute stroke presentation at the designated COVID-19 hospitals.
Methods: This retrospective observational study included all patients admitted to Yongchuan Hospital Affiliated to Chongqing Medical University with an acute stroke between January 24 and March 10, 2020. Patient demographics, characteristics of the stroke, treatment details, and clinical outcomes were compared with those of patients admitted in the corresponding period the year before (2019). Subgroup analysis was performed in the ischemic stroke group and the hemorrhagic stroke group.
Results: A total of 110 patients presented with acute stroke symptoms during the COVID-19 pandemic, compared to the 173 patients in the pre-COVID-19 period. A higher proportion of stroke patients during the pandemic presented to the hospital via emergency medical services (48.2% vs. 31.8%,  P=0.006), and had lower proportion of ischemic stroke  (50.9% vs. 65.3%, P=0.016) than stroke patients in the preceding year. Patients with 90 days mRS 3 points were significantly reduced in the COVID-19 period compared to the pre-COVID-19 period(17.3% vs. 30.6%, P=0.012).In the ischemic stroke comparison, the mean time from patient arrival to vessel puncture for emergency endovascular therapy in the COVID-19 period was shorter than that in the pre-COVID-19 period (109.1871.39 vs. 270.50161.51, P=0.002). In the hemorrhagic stroke comparison, the rate of emergency surgical operation in the COVID-19 period was higher than that in the pre-COVID-19 period (48.1% vs. 30.0%, P=0.047). the mean time from patient arrival to emergency surgical operation (15.3122.89 vs. 51.7240.47, P=0.002) in the COVID-19 period were shorter than that in the pre-COVID-19 period.
Conclusions: Although fewer acute stroke patients sought medical care in designated COVID-19 hospitals during the pandemic, these types of hospitals were more efficient for timely treatment of acute stroke. Recognizing how acute stroke presented in a designated COVID-19 hospital would contribute to appropriate acute stroke strategy adjustments in designated hospitals during COVID-19 and future pandemics.