Treat COVID-19, but not only COVID-19: Stroke matters as well

Background and Aims: During the COVID-19 pandemic, studies reported less hospitalizations for acute stroke and reduction in the use of recanalization treatments. This study analyzes nationwide data on stroke admissions and management in the Czech Republic early in the COVID-19 pandemic. Methods: To compare the early COVID-19 pandemic (March-May 2020) with the pre-pandemic period (January-February 2020 and March-May 2019): a) National Register of Reimbursed Health Services provided volume of all admissions for subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), and ischemic stroke (IS), and volume of recanalization treatments [intravenous thrombolysis (IVT) and mechanical thrombectomy (MT)];b) Registry of Stroke Care Quality provided door-to-needle time (DNT), onset-to-door time (ODT), and stroke severity at admission (NIHSS) for IS. Results: During the pandemic (March-May 2020), the maximum number of patients hospitalized for COVID in the CR was 422. In March-May 2020 vs. March-May 2019, hospital admissions decreased as following: stroke overall by 14%(p<0.001), IS by 14%(p<0.001), SAH by 15%(p=0.07), and ICH by 7% (p=0.17);the volumes of IVT and MT decreased by 14% (p=0.001) and 19% (p=0.01), respectively. DNTand ODT were 24 vs. 25 min (p=0.58) and 168 vs.156 min (p=0.23), respectively. Conclusions: Even with a low burden of COVID-19 and no change in organization of stroke services, stroke admissions and volume of recanalization treatments decreased. Public health communication campaigns should encourage people to seek emergency medical care for stroke symptoms during the COVID-19 pandemic. Data for the whole year 2020 will be available in June 2021.