Kataria Urvashi, Bhatt Rajat, Sharma Ashish, Arora Hobinder, Kaushal Himanshu
Department of Neurology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.
Department of Community Medicine, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.
J Family Med Prim Care. 2022 Jun;11(6):3217-3223. doi: 10.4103/jfmpc.jfmpc_2398_21. Epub 2022 Jun 30.
Coronavirus infectious disease (COVID-19) pandemic disrupted the already marginalized healthcare provision in resource limited countries like India.
This study compared onset to door time and temporal trends of admissions to seek medical care in new onset acute ischaemic stroke during the COVID-19 period with a representative pre-COVID-19 period in rural background.
Prospective Cross-sectional study in a tertiary level hospital in North India.
Study included new onset acute ischaemic stroke admitted within first 2 weeks of symptoms onset. Subjects were divided into: Group A - Pre-COVID-19 stroke, Group B - Non-COVID-19 Stroke, and Group C - Stroke, positive for COVID-19. Detailed epidemiological, clinical profile, onset to door time and temporal trends of admissions were recorded.
Chi square/Fisher's exact test and Independent Samples T test or Mann-Whitney U test were used for categorical and continuous variables.
Onset to door time in new onset acute ischaemic stroke was significantly prolonged by 6 h in COVID-19 period (median (interquartile range), 19 (12-27) h) as compared with pre-COVID-19 period. Admissions of new onset acute ischaemic stroke were significantly less in COVID-19 period. Comorbidities and severity of stroke (mean National Institutes of Health Stroke Scale, 20 ± 4) were more during the COVID-19 period. Incidence and mortality of COVID-19 positive new onset acute ischaemic stroke were 0.95% and 38%.
Onset to door time in new onset acute ischaemic stroke was significantly prolonged in COVID-19 as compared with pre-COVID-19 period. The admissions were fewer with more severity and comorbidities in COVID-19 period. COVID-19 positive stroke patients had more severity and mortality as compared with non-COVID-19 stroke.
冠状病毒感染疾病（COVID-19）大流行扰乱了印度等资源有限国家本就处于边缘地位的医疗服务。
本研究比较了COVID-19期间农村地区新发急性缺血性卒中患者从发病到入院的时间以及就医入院的时间趋势，并与具有代表性的COVID-19之前的时期进行对比。
在印度北部一家三级医院开展的前瞻性横断面研究。
研究纳入症状出现后前2周内入院的新发急性缺血性卒中患者。受试者分为：A组——COVID-19之前的卒中患者，B组——非COVID-19卒中患者，C组——COVID-19检测呈阳性的卒中患者。记录详细的流行病学、临床特征、从发病到入院的时间以及入院的时间趋势。
卡方检验/费舍尔精确检验以及独立样本t检验或曼-惠特尼U检验用于分类变量和连续变量。
与COVID-19之前的时期相比，COVID-19期间新发急性缺血性卒中患者从发病到入院的时间显著延长了6小时（中位数（四分位间距），19（12 - 27）小时）。COVID-19期间新发急性缺血性卒中的入院人数显著减少。COVID-19期间卒中的合并症和严重程度（平均国立卫生研究院卒中量表评分，20±4）更高。COVID-19检测呈阳性的新发急性缺血性卒中的发病率和死亡率分别为0.95%和38%。
与COVID-19之前的时期相比，COVID-19期间新发急性缺血性卒中患者从发病到入院的时间显著延长。COVID-19期间入院人数减少，病情更严重且合并症更多。与非COVID-19卒中患者相比，COVID-19检测呈阳性的卒中患者病情更严重且死亡率更高。
