The authors compared the first pandemic year (March 1, 2020, to February 28, 2021) overall and during the three COVID-19 waves with the preceding year. Volumes of acute ischemic stroke (AIS), subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), and recanalization treatments [intravenous thrombolysis (IVT) and mechanical thrombectomy (MT)] were obtained from the National Register of Reimbursed Health Services. Door-to-needle time (DNT), onset-to-door time (ODT), and NIHSS at admission were obtained from RES-Q. During the pandemic year as compared to the preceding year there were 26,453 vs 28,771 stroke admissions, representing an 8.8% decline (p<0.001). The decline (-10%, -11%, -19%) appeared in all COVID-19 waves (spring 2020, autumn 2020, winter 2021), except for an increase (2%) during summer 2020. Admissions for AIS declined by 10.2%, p<0.001), while hemorrhagic stroke volumes were minimally decreased. The absolute volumes of IVT and MT decreased by 9.4% (p<0.001) and 5.7% (p=0.16), respectively. However, the proportions of ischemic stroke patients receiving IVT (18% vs 18%; p=0.72) and MT (6% vs 6%; p=0.28) remained unchanged. The authors concluded that there was a decline in stroke admissions, but such decline was not related to COVID-19 incidence. The frequency of use of recanalization procedures (IVT, MT) and times (ODT, DNT) in AIS were preserved in the Czech Republic during the first year of the pandemic.
Sedova P, Kent JA, Bryndziar T, Jarkovsky J, Tomek A, Sramek M, Skoda O, Sramkova T, Pokorová K, Littnerova S, Brown RD Jr, Mikulik R. The decline in stroke hospitalization due to COVID-19 is unrelated to COVID-19 intensity. Eur J Neurol. 2022 Dec 13.
doi: 10.1111/ene.15664