Department of Neurology, National Cerebral and Cardiovascular Center.
Department of Stroke Neurology, National Hospital Organization Osaka National Hospital.
Neurol Med Chir (Tokyo). 2022 Aug 15;62(8):369-376. doi: 10.2176/jns-nmc.2022-0099. Epub 2022 Jun 24.
This study aimed to measure the impact of the COVID-19 pandemic on the volumes of annual stroke admissions compared with those before the pandemic in Japan. We conducted an observational, retrospective nationwide survey across 542 primary stroke centers in Japan. The annual admission volumes for acute stroke within 7 days from onset between 2019 as the pre-pandemic period and 2020 as the pandemic period were compared as a whole and separately by months during which the epidemic was serious and prefectures of high numbers of infected persons. The number of stroke patients declined from 182,660 in 2019 to 178,083 in 2020, with a reduction rate of 2.51% (95% confidence interval [CI], 2.58%-2.44%). The reduction rates were 1.92% (95% CI, 1.85%-2.00%; 127,979-125,522) for ischemic stroke, 3.88% (95% CI, 3.70%-4.07%, 41,906-40,278) for intracerebral hemorrhage, and 4.58% (95% CI, 4.23%-4.95%; 13,020-12,424) for subarachnoid hemorrhage. The admission volume declined by 5.60% (95% CI, 5.46%-5.74%) during the 7 months of 2020 when the epidemic was serious, whereas it increased in the remaining 5 months (2.01%; 95% CI, 1.91%-2.11%). The annual decline in the admission volume was predominant in the five prefectures with the largest numbers of infected people per million population (4.72%; 95% CI, 4.53%-4.92%). In conclusion, the acute stroke admission volume declined by 2.51% in 2020 relative to 2019 in Japan, especially during the months of high infection, and in highly infected prefectures. Overwhelmed healthcare systems and infection control practices may have been associated with the decline in the stroke admission volume during the COVID-19 pandemic.
这项研究旨在衡量 COVID-19 大流行对日本年度卒中入院量的影响，并将其与大流行前的入院量进行比较。我们在日本的 542 个初级卒中中心进行了一项观察性、回顾性全国性调查。比较了 2019 年大流行前和 2020 年大流行期间发病 7 天内的急性卒中的年度入院量，整体比较以及在疫情严重和感染人数较多的县分别按月比较。2020 年卒中患者人数从 2019 年的 182660 例降至 178083 例，下降率为 2.51%（95%置信区间[CI]，2.58%-2.44%）。缺血性卒中的下降率为 1.92%（95%CI，1.85%-2.00%；127979-125522），脑出血为 3.88%（95%CI，3.70%-4.07%，41906-40278），蛛网膜下腔出血为 4.58%（95%CI，4.23%-4.95%；13020-12424）。2020 年疫情严重的 7 个月期间，入院量下降了 5.60%（95%CI，5.46%-5.74%），而其余 5 个月则有所增加（2.01%；95%CI，1.91%-2.11%）。在每百万人口感染人数最多的五个县，年度入院量下降更为明显（4.72%；95%CI，4.53%-4.92%）。总之，与 2019 年相比，2020 年日本急性卒中入院量下降了 2.51%，尤其是在感染高峰期和感染人数较多的县。不堪重负的医疗体系和感染控制措施可能与 COVID-19 大流行期间卒中入院量下降有关。
