Gattringer Thomas, Fandler-Höfler Simon, Kneihsl Markus, Hofer Edith, Köle Wolfgang, Schmidt Reinhold, Tscheliessnigg Karl-Heinz, Frank Almut-Michaela, Enzinger Christian
Department of Neurology, Medical University of Graz, Auenbruggerplatz 22, 8042, Graz, Austria.
Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria.
J Neurol. 2021 Oct;268(10):3584-3588. doi: 10.1007/s00415-021-10488-8. Epub 2021 Feb 27.
We investigated hospital admission rates for the entire spectrum of acute cerebrovascular diseases and of recanalization treatments for ischaemic stroke (IS) in the Austrian federal state of Styria during and also after the first coronavirus disease 2019 (COVID-19) wave. We retrospectively identified all patients with transient ischaemic attack (TIA), IS and non-traumatic intracranial haemorrhage (ICH; including intracerebral, subdural and subarachnoid bleeding types) admitted to one of the 11 public hospitals in Styria (covering > 95% of inhospital cerebrovascular events in this region). Information was extracted from the electronic medical documentation network connecting all public Styrian hospitals. We analysed two periods of interest: (1) three peak months of the first COVID-19 wave (March-May 2020), and (2) three recovery months thereafter (June-August 2020), compared to respective periods 4 years prior (2016-2019) using Poisson regression. In the three peak months of the first COVID-19 wave, there was an overall decline in hospital admissions for acute cerebrovascular diseases (RR = 0.83, 95% CI 0.78-0.89, p < 0.001), which was significant for TIA (RR = 0.61, 95% CI 0.52-0.72, p < 0.001) and ICH (0.78, 95% CI 0.67-0.91, p = 0.02), but not for IS (RR = 0.93, 95% CI 0.85-1, p = 0.08). Thrombolysis and thrombectomy numbers were not different compared to respective months 4 years prior. In the recovery period after the first COVID-19 wave, TIA (RR = 0.82, 95% CI 0.71-0.96, p = 0.011) and ICH (RR = 0.86, 95% CI 0.74-0.99, p = 0.045) hospitalizations remained lower, while the frequency of IS and recanalization treatments was unchanged. In this state-wide analysis covering all types of acute cerebrovascular diseases, hospital admissions for TIA and ICH were reduced during and also after the first wave of the COVID-19 pandemic, but hospitalizations and recanalization treatments for IS were not affected in these two periods.
我们调查了奥地利施蒂利亚州在2019年冠状病毒病（COVID-19）第一波疫情期间及之后，各类急性脑血管疾病的住院率以及缺血性卒中（IS）的再通治疗情况。我们回顾性地确定了所有入住施蒂利亚州11家公立医院之一的短暂性脑缺血发作（TIA）、IS和非创伤性颅内出血（ICH；包括脑内、硬膜下和蛛网膜下腔出血类型）患者（涵盖该地区超过95%的住院脑血管事件）。信息从连接施蒂利亚州所有公立医院的电子医疗文档网络中提取。我们分析了两个感兴趣的时期：（1）COVID-19第一波疫情的三个高峰月（2020年3月至5月），以及（2）此后的三个恢复月（2020年6月至8月），并使用泊松回归将其与4年前（2016 - 2019年）的相应时期进行比较。在COVID-19第一波疫情的三个高峰月，急性脑血管疾病的住院人数总体下降（RR = 0.83，95% CI 0.78 - 0.89，p < 0.001），这在TIA（RR = 0.61，95% CI 0.52 - 0.72，p < 0.001）和ICH（0.78，95% CI 0.67 - 0.91，p = 0.02）方面具有统计学意义，但在IS方面无统计学意义（RR = 0.93，95% CI 0.85 - 1，p = 0.08）。与4年前的相应月份相比，溶栓和取栓数量没有差异。在COVID-19第一波疫情后的恢复期，TIA（RR = 0.82，95% CI 0.71 - 0.96，p = 0.011）和ICH（RR = 0.86，95% CI 0.74 - 0.99，p = 0.045）的住院人数仍然较低，而IS和再通治疗的频率没有变化。在这项涵盖所有类型急性脑血管疾病的全州分析中，COVID-19大流行第一波期间及之后，TIA和ICH的住院人数减少，但这两个时期IS的住院人数和再通治疗未受影响。
