Hospital Vitória e Samaritano, Americas Serviços Medicos, United Health Group Brazil, Barra, Avenida Jorge Curi 550, Bloco A, Rio de Janeiro, RJ CEP 22775-001, Brazil.
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Hospital A.C. Camargo Cancer Center, São Paulo, Brazil.
J Stroke Cerebrovasc Dis. 2022 May;31(5):106405. doi: 10.1016/j.jstrokecerebrovasdis.2022.106405. Epub 2022 Feb 21.
We aimed to evaluate the relationship between social distancing, stroke admissions and stroke mortality during the COVID-19 pandemic, while accounting for the rate of COVID-19 admissions.
We performed a longitudinal analysis of a multicenter, prospective, hospital-based registry of intensive care units from 19 hospitals from Brazil, comprising a 14-month period of the COVID-19 pandemic. We investigated whether the daily rate of admissions (DRA) and daily mortality rate for stroke were associated with the social distancing index (SDI), taking into account the daily rate of admissions for COVID-19 (DRA) in univariate and multivariate regression models. We also compared the clinical characteristics of patients with stroke admitted before and during the pandemic.
We found that DRA decreased significantly in association with a strong rise in the SDI during the early months of the pandemic. However, in the latter period of the pandemic, only minor changes were observed in the SDI, and still, DRA was inversely associated with the DRA. Throughout the pandemic, higher SDI and DRA were associated with higher in-hospital mortality for stroke.
The severity of surges of the COVID-19 pandemic were independently and persistently associated with declines in stroke admissions, even during periods when social distancing policies were not intensified.
本研究旨在评估 COVID-19 大流行期间社会隔离程度与卒中入院率和卒中死亡率之间的关系，并考虑 COVID-19 入院率的影响。
我们对来自巴西 19 家医院的多中心、前瞻性、基于医院的重症监护室注册中心进行了纵向分析，该研究涵盖了 COVID-19 大流行的 14 个月。我们通过单变量和多变量回归模型，研究了每日卒中入院率（DRA）和卒中每日死亡率是否与社会隔离指数（SDI）相关，同时考虑了 COVID-19 每日入院率（DRA）。我们还比较了大流行前后入院卒中患者的临床特征。
我们发现，在 COVID-19 大流行早期，SDI 大幅上升与 DRA 显著下降相关。然而，在大流行后期，SDI 仅有微小变化，而 DRA 仍与 SDI 呈负相关。在整个大流行期间，较高的 SDI 和 DRA 与卒中住院死亡率升高相关。
COVID-19 大流行严重程度的波动与卒中入院率下降独立且持续相关，即使在社会隔离政策没有加强的时期也是如此。
