About: Decline in stroke alerts and hospitalisations during the COVID-19 pandemic

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An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Decline in stroke alerts and hospitalisations during the COVID-19 pandemic
Creator	Aparicio, Hugo Boehme, Amelia Burton, Tina Clark, Judith Elkind, Mitchell Greer, David Lioutas, Vasileios-Arsenios Madsen, Tracy Marshall, Randolph O'sullivan, Jillian Selim, Magdy Sharma, Malveeka Tirschwell, David Willey, Joshua
Source	Medline; PMC
abstract	INTRODUCTION: Patients with stroke-like symptoms may be underutilising emergency medical services and avoiding hospitalisation during the COVID-19 pandemic. We investigated a decline in admissions for stroke and transient ischaemic attack (TIA) and emergency department (ED) stroke alert activations. METHODS: We retrospectively compiled total weekly hospital admissions for stroke and TIA between 31 December 2018 and 21 April 2019 versus 30 December 2019 and 19 April 2020 at five US tertiary academic comprehensive stroke centres in cities with early COVID-19 outbreaks in Boston, New York City, Providence and Seattle. We collected available data on ED stroke alerts, stroke severity using the National Institutes of Health Stroke Scale (NIHSS) and time from symptom onset to hospital arrival. RESULTS: Compared with 31 December 2018 to 21 April 2019, a decline in stroke/TIA admissions and ED stroke alerts occurred during 30 December 2019 to 19 April 2020 (p trend <0.001 for each). The declines coincided with state stay-at-home recommendations in late March. The greatest decline in hospital admissions was observed between 23 March and 19 April 2020, with a 31% decline compared with the corresponding weeks in 2019. Three of the five centres with 2019 and 2020 stroke alert data had a 46% decline in ED stroke alerts in late March and April 2020, compared with 2019. Median baseline NIHSS during these 4 weeks was 10 in 2020 and 7 in 2019. There was no difference in time from symptom onset to hospital arrival. CONCLUSION: At these five large academic US hospitals, admissions for stroke and TIA declined during the COVID-19 pandemic. There was a trend for fewer ED stroke alerts at three of the five centres with available 2019 and 2020 data. Acute stroke therapies are time-sensitive, so decreased healthcare access or utilisation may lead to more disabling or fatal strokes, or more severe non-neurological complications related to stroke. Our findings underscore the indirect effects of this pandemic. Public health officials, hospital systems and healthcare providers must continue to encourage patients with stroke to seek acute care during this crisis.
has issue date	2020-08-20(xsd:dateTime)
bibo:doi	10.1136/svn-2020-000441
bibo:pmid	32855352
has license	cc-by-nc
sha1sum (hex)	440af7991231a51514a56affc3c1280e9e636e81
schema:url	https://doi.org/10.1136/svn-2020-000441
resource representing a document's title	Decline in stroke alerts and hospitalisations during the COVID-19 pandemic
has PubMed Central identifier	PMC7453762
has PubMed identifier	32855352
schema:publication	Stroke Vasc Neurol
resource representing a document's body	covid:440af7991231a51514a56affc3c1280e9e636e81#body_text
is schema:about of	named entity 'stroke' named entity 'COVID-19' named entity 'HOSPITAL ADMISSIONS' named entity 'HOSPITALISATION' named entity 'TIA' named entity 'ADMISSIONS' named entity 'stroke-like symptoms' named entity 'TIA' named entity 'TIA' named entity 'hospital admissions' named entity 'COVID-19 pandemic' named entity 'stroke-like symptoms' named entity 'stroke' named entity 'symptom' named entity 'transient ischaemic attack' named entity 'stroke' named entity 'Boston' named entity 'ischaemic' named entity 'stroke' named entity 'outpatient clinics' named entity 'neurological complications' named entity 'stroke' named entity 'stroke' named entity 'stroke' named entity 'stroke' named entity 'time series' named entity 'stroke' named entity 'NIHSS' named entity 'urban flight' named entity 'stroke' named entity 'National Institutes of Health Stroke Scale' named entity 'COVID-19' named entity 'stroke' named entity 'TIA' named entity 'stroke' named entity 'TIA' named entity 'TIA' named entity 'stroke' named entity '13 March' named entity 'transient ischaemic attack' named entity 'emergency services' named entity 'time series' named entity 'disability' named entity 'stroke symptoms' named entity 'stroke' named entity 'ischaemic stroke' named entity 'stroke' named entity 'Wilcoxon rank-sum test' named entity 'stroke' named entity 'stroke' named entity 'New York City' named entity 'Fisher's exact test' named entity 'stroke' named entity 'COVID-19' named entity 'Public health' named entity 'Boston' named entity 'Acute stroke' named entity 'stroke' named entity 'stroke' named entity 'COVID-19 pandemic' named entity 'WHO' named entity 'symptom' named entity 'symptom' named entity 'stroke' named entity 'NIHSS' named entity 'COVID-19' named entity 'stroke' named entity 'stroke'

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