Department of Neurology, The Medical City, Pasig City, Philippines.
Department of Neurosciences, University of the Philippines-College of Medicine, Manila, Philippines.
Cerebrovasc Dis Extra. 2022;12(2):76-84. doi: 10.1159/000525057. Epub 2022 May 19.
The COVID-19 pandemic has been continuing its global spread ever since its onset, and efforts to curb the infection in multiple reports have contrasting effects on stroke severity, admissions, and outcomes. In the Philippines, where the COVID-19 pandemic shows no signs of slowing down and has been in the world's longest lockdown, we investigated the effect of the pandemic in the stroke admissions and outcomes in one of the largest tertiary hospitals in the Philippines.
This is a retrospective, comparative study of all adult stroke patients admitted between pre-COVID-19 (February 2019-January 2020) and COVID-19 periods (February 2020-January 2021). The differences of stroke types, severity, classification, and discharge outcomes between pre-COVID-19 and during COVID-19 were analyzed in the study.
There is a decrease in total number of stroke admissions from 597 in the pre-COVID-19 period to 487 during the pandemic. Stroke patients take significantly longer time to seek hospital consultation from the onset of stroke symptoms, and significantly higher proportion of patients have moderate and severe stroke. The discharge outcome showed significantly higher proportions of dependency upon discharge (13%) and higher proportion of death in stroke patients from 7% pre-CO-VID-19 pandemic to 13% during the pandemic.
There was reduction in total stroke admissions, mild and transient stroke during the pandemic. There were a significantly higher proportion of stroke patients having moderate and severe stroke. The discharge outcome of stroke patients is functionally poorer during the pandemic, and more stroke patients have died compared before the COVID-19 pandemic.
自 COVID-19 疫情爆发以来,其一直在全球范围内持续传播,多项报告中遏制感染的努力对卒中严重程度、入院和结局的影响各不相同。在菲律宾,COVID-19 疫情没有放缓的迹象,且该国一直处于世界上时间最长的封锁之中,我们调查了疫情对菲律宾最大的三级医院之一的卒中入院和结局的影响。
这是一项回顾性、对比研究,纳入了所有在 COVID-19 前(2019 年 2 月-2020 年 1 月)和 COVID-19 期间(2020 年 2 月-2021 年 1 月)入住的成年卒中患者。分析了 COVID-19 前和 COVID-19 期间卒中类型、严重程度、分类和出院结局的差异。
与 COVID-19 前相比,卒中总入院人数从 597 例减少至 487 例。卒中患者从发病到就诊的时间明显延长,且中度和重度卒中的比例明显更高。出院结局显示,依赖于他人的出院比例(13%)显著升高,且卒中患者的死亡率(COVID-19 前为 7%,COVID-19 期间为 13%)也更高。
在疫情期间,总卒中入院、轻度和短暂性卒中减少。中度和重度卒中的患者比例明显更高。与 COVID-19 前相比,卒中患者的出院结局在功能上更差,且更多的卒中患者死亡。