Stroke profile and care during the COVID-19 pandemic: What changed and what did not? A prospective cohort from Joinville, Brazil

Frontiers in Neurology

Neurology

Carla Heloisa Cabral Moro¹  Pedro Silva Correa de Magalhães¹  Henrique Diegoli¹  Alexandre Luiz Longo¹  Felipe Ibiapina dos Reis²  Marcos Christiano Lange³  Viviane Flumignan Zétola³  Juliana Antunes Safanelli⁴  Vivian Nagel⁴ 

[1] Division of Neurology, Hospital Municipal São José, Joinville, Santa Catarina, Brazil;Division of Neurology, University of Joinville's Region, Joinville, Santa Catarina, Brazil;Federal University of Paraná, Hospital de Clínicas, Curitiba, Paraná, Brazil;Hospital Municipal São José, Joinville Stroke Registry, Joinville, Santa Catarina, Brazil;

关键词: stroke care;    stroke profile;    epidemiology;    mortality;    incidence;    COVID-19;    coronavirus;   

DOI  :  10.3389/fneur.2023.1122875

 received in 2022-12-13, accepted in 2023-01-27,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionThe COVID-19 pandemic has wrought negative consequences concerning quality of care for stroke patients since its onset. Prospective population-based data about stroke care in the pandemic are limited. This study aims to investigate the impact of COVID-19 pandemic on stroke profile and care in Joinville, Brazil.MethodsA prospective population-based cohort enrolled the first-ever cerebrovascular events in Joinville, Brazil, and a comparative analyzes was conducted between the first 12 months following COVID-19 restrictions (starting March 2020) and the 12 months just before. Patients with transient ischemic attack (TIA) or stroke had their profiles, incidences, subtypes, severity, access to reperfusion therapy, in-hospital stay, complementary investigation, and mortality compared.ResultsThe profiles of TIA/stroke patients in both periods were similar, with no differences in gender, age, severity, or comorbidities. There was a reduction in incidence of TIA (32.8%; p = 0.003). In both periods, intravenous thrombolysis (IV) and mechanical thrombectomy (MT) rates and intervals from door to IV/MT were similar. Patients with cardioembolic stroke and atrial fibrillation had their in-hospital stay abbreviated. The etiologic investigation was similar before and during the pandemic, but there were increases in cranial tomographies (p = 0.02), transthoracic echocardiograms (p = 0.001), chest X-rays (p < 0.001) and transcranial Doppler ultrasounds (p < 0.001). The number of cranial magnetic resonance imaging decreased in the pandemic. In-hospital mortality did not change.DiscussionThe COVID-19 pandemic is associated with a reduction in TIA, without any influence on stroke profile, the quality of stroke care, in-hospital investigation or mortality. Our findings show an effective response by the local stroke care system and offer convincing evidence that interdisciplinary efforts are the ideal approach to avoiding the COVID-19 pandemic's negative effects, even with scarce resources.

【 授权许可】

Unknown   
Copyright © 2023 dos Reis, de Magalhães, Diegoli, Longo, Moro, Safanelli, Nagel, Lange and Zétola.