Tanaka Koji, Matsumoto Shoji, Nakazawa Yusuke, Yamada Takeshi, Sonoda Kazutaka, Nagano Sukehisa, Hatano Taketo, Yamasaki Ryo, Nakahara Ichiro, Isobe Noriko
Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Comprehensive Strokology, Fujita Health University School of Medicine, Toyoake, Japan.
Front Neurol. 2021 Oct 27;12:748316. doi: 10.3389/fneur.2021.748316. eCollection 2021.
Coronavirus Disease 2019 (COVID-19) has spread worldwide with collateral damage and therefore might affect the behavior of stroke patients with mild symptoms seeking medical attention. Patients with ischemic stroke who were admitted to hospitals within 7 days of onset were retrospectively registered. The clinical characteristics, including onset-to-door time (ODT), of patients with a transient ischemic attack (TIA)/mild stroke (National Institutes of Health Stroke Scale [NIHSS] score of ≤ 3 on admission) or moderate/severe stroke were compared between those admitted from April 2019 to March 2020 (pre-COVID-19 period) and from April to September 2020 (COVID-19 period). Multivariable regression analysis was performed to identify factors associated with the ODT. Of 1,100 patients (732 men, median age, 73 years), 754 were admitted during the pre-COVID-19 period, and 346 were admitted during the COVID-19 period. The number and proportion of patients with TIA/minor stroke were 464 (61.5%) in the pre-COVID-19 period and 216 (62.4%) during the COVID-19 period. Among patients with TIA/mild stroke, the ODT was longer in patients admitted during the COVID-19 period compared with that of the pre-COVID-19 period (median 864 min vs. 508 min, = 0.003). Multivariable analysis revealed the COVID-19 period of admission was associated with longer ODT (standardized partial regression coefficient 0.09, = 0.003) after adjustment for age, sex, route of arrival, NIHSS score on admission, and the presence of hypertension, diabetes mellitus, and wake-up stroke. No significant change in the ODT was seen in patients with moderate/severe stroke. The COVID-19 epidemic might increase the ODT of patients with TIA/mild stroke.
2019年冠状病毒病（COVID-19）已在全球范围内传播并造成附带损害，因此可能会影响有轻微症状的中风患者寻求医疗救治的行为。回顾性登记了发病7天内入院的缺血性中风患者。比较了2019年4月至2020年3月（COVID-19大流行前时期）和2020年4月至9月（COVID-19时期）入院的短暂性脑缺血发作（TIA）/轻度中风（入院时美国国立卫生研究院卒中量表[NIHSS]评分≤3）或中度/重度中风患者的临床特征，包括发病至入院时间（ODT）。进行多变量回归分析以确定与ODT相关的因素。在1100例患者（732例男性，中位年龄73岁）中，754例在COVID-19大流行前时期入院,346例在COVID-19时期入院。TIA/轻度中风患者的数量和比例在COVID-19大流行前时期为464例（61.5%），在COVID-19时期为216例（62.4%）。在TIA/轻度中风患者中，COVID-19时期入院患者的ODT比COVID-19大流行前时期更长（中位时间864分钟对508分钟，P = 0.003）。多变量分析显示，在调整年龄、性别、到达途径、入院时NIHSS评分以及高血压、糖尿病和醒后卒中的存在情况后，COVID-19时期入院与更长的ODT相关（标准化偏回归系数0.09，P = 0.003）。中度/重度中风患者的ODT没有显著变化。COVID-19大流行可能会增加TIA/轻度中风患者的ODT时间。
