National Neuroscience Institute, Singapore.
Ann Acad Med Singap. 2020 Aug;49(8):538-542.
The coronavirus disease 2019 (COVID-19) outbreak is affecting hospital admissions of stroke patients. This, in turn, will reduce the use of proven stroke treatments, which will result in poorer stroke outcomes. We examined local stroke admissions before, during, and after the 2003 outbreak of the severe acute respiratory syndrome (SARS) (these periods being defined in both the Singapore and worldwide contexts), to extrapolate stroke admission patterns in Singapore during the current COVID-19 crisis.
National inpatient admission data from the Ministry of Health (MOH), Singapore, and death data from the Registry of Births and Deaths (RBD), Singapore, were analysed. Trends of local stroke admissions and stroke-related mortality pre-SARS, during SARS, and post-SARS periods, both in the Singapore and worldwide contexts, were analysed using time series plot in monthly time units. Differences between periods were presented as percentage change between: (1) SARS and pre-SARS periods, and (2) post-SARS and SARS periods and compared using two-sample t-tests.
There was a 19% decline in stroke admissions into all local hospitals during the Singapore SARS period ( = 0.002) and a 13% reduction during the worldwide SARS period ( = 0.006). Stroke admissions increased by 18% after the Singapore SARS period was over ( = 0.003) and rose by a further 8% when the worldwide SARS period ended ( = 0.046). Stroke-related mortality remained stable throughout.
During the SARS pandemic, there was a reduction in the number of stroke admissions, and this was apparent during both the local SARS and worldwide SARS outbreak periods. We should take appropriate steps through public education to minimise the expected reduced stroke admissions during the COVID-19 pandemic, inferred from the findings during the SARS pandemic.
2019 年冠状病毒病（COVID-19）疫情正在影响卒中患者的住院人数。这反过来又会减少对已证实的卒中治疗方法的使用，从而导致卒中结局较差。我们检查了 2003 年严重急性呼吸系统综合征（SARS）爆发前后（新加坡和全球范围内的这两个时期都有定义）当地的卒中入院情况，以推断新加坡在当前 COVID-19 危机期间的卒中入院模式。
分析了来自新加坡卫生部（MOH）的国家住院入院数据和新加坡出生和死亡登记处（RBD）的死亡数据。使用月度时间单位的时间序列图分析了 SARS 之前、期间和之后的当地卒中入院和与卒中相关的死亡率趋势，包括新加坡和全球范围内的趋势。使用两样本 t 检验比较了各时期之间的差异，差异表示为 SARS 和 SARS 前时期之间（1）和 SARS 和 SARS 后时期之间（2）的百分比变化。
在新加坡 SARS 期间，所有本地医院的卒中入院人数下降了 19%（ = 0.002），全球 SARS 期间下降了 13%（ = 0.006）。新加坡 SARS 结束后，卒中入院人数增加了 18%（ = 0.003），全球 SARS 结束后又增加了 8%（ = 0.046）。与卒中相关的死亡率保持稳定。
在 SARS 大流行期间，卒中入院人数减少，这在当地 SARS 和全球 SARS 爆发期间都很明显。我们应该通过公众教育采取适当措施，尽量减少 COVID-19 大流行期间预计会减少的卒中入院人数，这是从 SARS 大流行期间的发现推断出来的。
