Impact of the COVID-19 pandemic on the stroke cases notification in Brazil

Background and aims: The Coronavirus Disease Pandemic - 2019 (COVID-19) represents, to date, the greatest public health challenge of the 21st century. Stroke, on the other hand, is nationally the main cause of disability, accompanied by a considerable and costly number of hospitalizations. This paper questions the impact of COVID-19 on stroke notifications. Methods: Articles were searched using the descriptors: Ischemic Stroke;Hemorrhagic Stroke;Cerebrovascular events;COVID-19 and Brazil. The research platforms were Pubmed, Scielo, Virtual Health Library and DataSUS. Results: Since the beginning of the pandemic in Brazil, in March 2020, there has been a reduction of approximately 20% in the number of stroke cases reported compared to 2019. This reality is consistent with the international scenario of possible underreporting and reduced demand for medical care in mild and intermediate cases. Although, according to medical societies of national specialties, COVID-19 does not change the recommendations for the management of patients with stroke, the result of this context may be a late start of care, loss of the therapeutic window and worsening of stroke outcomes in the country. The attention to safety protocols and the importance of telemedicine for pre-hospital care was also highlighted. Conclusion: Given the decrease in the number of cases of stroke, there is an alert regarding underreporting and delay in care, problems already present in the national scenario that may be potentiated by the pandemic, where the concern with COVID-19 overlaps with other diseases, which may increase the damage (in the short and long term) to public health.