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

Stroke & Vascular Neurology 2020年第4期5卷 403-405页

作者： Malveeka Sharma Vasileios-Arsenios Lioutas Tracy Madsen Judith Clark Jillian O'Sullivan Mitchell S.VElkind Joshua Z.Willey Randolph S.Marshall Magdy H.Selim David Greer David L.Tirschwell tina burton Amelia Boehme Hugo J.Aparicio Department of Neurology University of Washington School of MedicineSeattleWashingtonUSA Department of Neurology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA Deparment of Emergency Medicine Brown UniversityProvidenceRhode IslandUSA Department of Neurology Boston University School of MedicineBostonMassachusettsUSA Department of Neurology Vagelos College of Physicians and SurgeonColumbia UniversityNew YorkNew YorkUSA Department of Epidemiology Mailman School of Public HealthColumbia UniversityNew YorkNew YorkUSA Department of Neurology Brown UniversityProvidenceRhode IslandUSA

Introduction Patients with stroke-like symptoms may be underutilising emergency medical services and avoiding hospitalisation during the COVID-19 *** investigated a decline in admissions for stroke and transient ischaemic attack(TIA)and emergency department(ED)stroke alert *** 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 *** 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 *** 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 *** greatest decline in hospital admissions was observed between 23 March and 19 April 2020,with a 31%decline compared with the corresponding weeks in *** 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 *** baseline NIHSS during these 4 weeks was 10 in 2020 and 7 in *** was no difference in time from symptom onset to hospital *** At these five large academic US hospitals,admissions for stroke and TIA declined during the COVID-19 *** was a trend for fewer ED stroke alerts at three of the five centres with available 2019 and 2020 *** 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 *** findings underscore the indirect effects of this *** health offici

关键词： alert centre hospital

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