Departments of Neurology, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15218, United States.
Departments of Emergency, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
J Stroke Cerebrovasc Dis. 2020 Aug;29(8):104988. doi: 10.1016/j.jstrokecerebrovasdis.2020.104988. Epub 2020 Jun 10.
The COVID-19 pandemic's impact on stroke care is two-fold direct impact of the infection and indirect impact on non-COVID-19 diseases. Anecdotal evidence and clinical observation suggest that there is a decrease in the number of patients presenting with stroke during the pandemic. We aim to understand the impact of the COVID-19 pandemic on the utilization of stroke emergency services on a single comprehensive stroke center (CSC).
We performed a retrospective analysis of a prospectively maintained database and compared all emergency department (ED) encounters, acute stroke admissions (including TIA), and thrombectomy cases admitted in March 2017-2019 to patients admitted in March 2020 at a comprehensive stroke center.
Number of total ED encounters (22%, p=0.005), acute ischemic strokes (40%, p=0.001), and TIAs (60%, p=0.163) decreased between March of 2017-2019 compared to March of 2020. The number of patients undergoing EVT in March 2020 was comparable to March 2017-2019 (p=0.430).
A pandemic-related stay-at-home policy reduces the utilization of stroke emergency services at a CSC. This effect appears to be more prominent for ED encounters, all stroke admissions and TIAs, and less impactful for severe strokes. Given the relatively low prevalence of COVID-19 cases in our region, this decrement is likely related to healthcare seeking behavior rather than capacity saturation.
COVID-19 大流行对中风护理的影响有两方面：感染的直接影响和非 COVID-19 疾病的间接影响。一些传闻证据和临床观察表明，大流行期间中风患者的数量有所减少。我们旨在了解 COVID-19 大流行对单一综合中风中心（CSC）中风急救服务利用的影响。
我们对前瞻性维护的数据库进行了回顾性分析，并将 2017 年 3 月至 2019 年 3 月期间在综合中风中心收治的所有急诊部（ED）就诊、急性中风入院（包括 TIA）和血栓切除术病例与 2020 年 3 月收治的患者进行比较。
2017 年 3 月至 2019 年 3 月与 2020 年 3 月相比，ED 就诊总人数（22%，p=0.005）、急性缺血性中风（40%，p=0.001）和 TIA（60%，p=0.163）减少。2020 年 3 月接受 EVT 的患者数量与 2017 年 3 月至 2019 年 3 月相比无差异（p=0.430）。
与大流行相关的居家政策减少了 CSC 中风急救服务的利用。这种影响在 ED 就诊、所有中风入院和 TIA 中更为明显，而对严重中风的影响较小。鉴于我们所在地区 COVID-19 病例的相对低流行率，这种减少可能与医疗寻求行为而非能力饱和有关。
