Underutilization of health care for strokes during the COVID-19 outbreak.
Reads0
Chats0
TLDR
In those who presented to the hospitals, the likelihood of stroke patients receiving IV tPA was higher in both control groups as compared to the study period, and the likelihood that they would be diagnosed with ischemic stroke was higher than in the other groups.Abstract:
Objective: To analyze impact of COVID-19 Pandemic on acute stroke care. Background: At the offset of Pandemic, a decrease in utilization of healthcare in medical emergencies like acute ischemic stroke and Myocardial Infarction was observed. Design/Methods: We collected stroke data from TriNetX network research platform. We analyzed number of ischemic stroke patients greater than 18 years, intravenous tissue plasminogen activator (IV tPA) administration and mechanical thrombectomy (MT) in Study group (SG) from 20 January 2020 to 16 May 2020 and compared them with two control groups (CGs): control group 1 (CG1) from 20 January 2019 to 16 May 2019 and control group 2 (CG2) from 25 September 2019 to 19 January 2020. We used Bonferroni's method to correct for multiple comparisons and alpha of 0.01 was considered significant. Results: There was 43% decrease in number of stroke patients in SG compared to CG1 and 25.5% decrease compared to CG2. In the SG, there was drop in number of IV tPA administrations 51% and 35%, and MT by 39% and 27% compared to CG1 and CG2 respectively. Likelihood of stroke patients receiving IV tPA was higher in both CGs compared to the SG (X =8.95, p=0.002 for CG1, and X =6.59, p=0.010 for CG2). There was no significant difference in MT between groups. There were 287 (0.8%) stroke patients with diagnosis of COVID-19 in SG. When COVID-19 positive patients were compared to COVID-19 negative patients, younger patients were significantly overrepresented in COVID-19 positive group (X =8.75, p=0.003). Conclusions: There was substantial drop in number of stroke patients seeking medical help in the SG, suggesting that people with strokes were not presenting to hospitals during study period, likely due to concerns contracting SARS-CoV2 in hospital. Younger patients were overrepresented in COVID-19 strokes suggesting possible increased risk of strokes due to hypercoagulable state with COVID-19.read more
Citations
More filters
Journal ArticleDOI
Spectrum of neuropsychiatric manifestations in COVID-19.
Krishna Nalleballe,Sanjeeva Onteddu,Rohan Sharma,Vasuki Dandu,Aliza T. Brown,Madhu Jasti,Sisira Yadala,Karthika Veerapaneni,Suman Siddamreddy,Akshay Avula,Nidhi Kapoor,Kamran Mudassar,Sukanthi Kovvuru +12 more
TL;DR: Early recognition and prompt management of neuropsychiatric manifestations in patients diagnosed with COVID-19 have a potential to decrease overall morbidity and mortality.
Journal ArticleDOI
Global impact of COVID-19 on stroke care.
Raul G Nogueira,Mohamad Abdalkader,Muhammed M. Qureshi,Michael Frankel,Ossama Mansour,Hiroshi Yamagami,Zhongming Qiu,Mehdi Farhoudi,James E. Siegler,Shadi Yaghi,Eytan Raz,Nobuyuki Sakai,Nobuyuki Ohara,Michel Piotin,Laura Mechtouff,Omer Eker,Vanessa Chalumeau,Timothy Kleinig,Raoul Pop,Jianmin Liu,Hugh Stephen Winters,Xianjin Shang,Alejandro Rodriguez Vasquez,Jordi Blasco,Juan F. Arenillas,Mario Martínez-Galdámez,Alex Brehm,Marios-Nikos Psychogios,Pedro Lylyk,Diogo C Haussen,Alhamza R Al-Bayati,Mahmoud H Mohammaden,Luisa Fonseca,M. Luis Silva,Francisco Mont’Alverne,Leonardo Renieri,Salvatore Mangiafico,Urs Fischer,Jan Gralla,Donald Frei,Chandril Chugh,Brijesh P Mehta,Simon Nagel,Markus A Möhlenbruch,Santiago Ortega-Gutierrez,Mudassir Farooqui,Ameer E Hassan,Allan Taylor,Bertrand Lapergue,Arturo Consoli,Bruce C.V. Campbell,Malveeka Sharma,Melanie Walker,Noel van Horn,Jens Fiehler,Huy Thang Nguyen,Quoc Trung Nguyen,Daisuke Watanabe,Hao Zhang,Huynh Vu Le,Viet Quy Nguyen,Ruchir Shah,Thomas Devlin,Priyank Khandelwal,Italo Linfante,Wazim Izzath,Pablo M. Lavados,Verónica V. Olavarría,Gisele Sampaio Silva,Anna Verena de Carvalho Sousa,Jawad F. Kirmani,Martin Bendszus,Tatsuo Amano,Ryoo Yamamoto,Ryosuke Doijiri,Naoki Tokuda,Takehiro Yamada,Tadashi Terasaki,Yukako Yazawa,Jane G. Morris,Emma Griffin,John Thornton,Pascale Lavoie,Charles C. Matouk,Michael D. Hill,Andrew M. Demchuk,Monika Killer-Oberpfalzer,Fadi Nahab,Dorothea Altschul,Anna Ramos-Pachón,Natalia Pérez de la Ossa,Raghid Kikano,William Boisseau,Gregory Walker,Steve M. Cordina,Ajit S. Puri,Anna Luisa Kühn,Dheeraj Gandhi,Pankajavalli Ramakrishnan,Roberta Novakovic-White,Alex Bou Chebl,Odysseas Kargiotis,Alexandra L Czap,Alicia Zha,Hesham Masoud,Carlos Ynigo Lopez,David Ozretić,Fawaz Al-Mufti,Wenjie Zie,Zhenhui Duan,Zhengzhou Yuan,Wenguo Huang,Yonggang Hao,Jun Luo,Vladimir Kalousek,Romain Bourcier,Romain Guile,Steven W. Hetts,Hosam Al-Jehani,Adel Alhazzani,Elyar Sadeghi-Hokmabadi,Mohamed Teleb,Jeremy Payne,Jin Soo Lee,Ji Man Hong,Sung Il Sohn,Yang-Ha Hwang,Dong Hoon Shin,Hong Gee Roh,Randy Edgell,Rakesh Khatri,Ainsley Smith,Amer M. Malik,David S Liebeskind,Nabeel Herial,Pascal Jabbour,Pedro S.C. Magalhães,Atilla Özcan Özdemir,Özlem Aykaç,Takeshi Uwatoko,Tomohisa Dembo,Hisao Shimizu,Yuri Sugiura,Fumio Miyashita,Hiroki Fukuda,Kosuke Miyake,Junsuke Shimbo,Yusuke Sugimura,André Beer-Furlan,Krishna C Joshi,Luciana Catanese,Daniel Giansante Abud,Octavio Giansante Neto,Masoud Mehrpour,Amal Al Hashmi,Mahar Saqqur,Abdulrahman Mostafa,Johanna T Fifi,Syed T. Hussain,Seby John,Rishi Gupta,Rotem Sivan-Hoffmann,Anna Reznik,Achmad Fidaus Sani,Serdar Geyik,Eşref Akıl,Anchalee Churojana,Abdoreza Ghoreishi,Mohammad Saadatnia,Ehsan Sharifipour,Alice Ma,Ken Faulder,Teddy Y. Wu,Lester Y. Leung,Adel M. Malek,Barbara Voetsch,Ajay K. Wakhloo,Rodrigo Rivera,Danny Moises Barrientos Iman,Aleksandra Pikula,Vasileios-Arsenios Lioutas,Götz Thomalla,Lee Birnbaum,Paolo Machi,Gianmarco Bernava,Mollie McDermott,Dawn Kleindorfer,Ken Wong,Mary S. Patterson,Jose Antonio Fiorot,Vikram Huded,William J. Mack,Matthew S. Tenser,Clifford J. Eskey,Sumeet Multani,Michael Kelly,Vallabh Janardhan,Oriana Cornett,Varsha Singh,Yuichi Murayama,Maxim Mokin,Pengfei Yang,Xiaoxi Zhang,Congguo Yin,Hongxing Han,Ya Peng,Wenhuo Chen,Roberto Crosa,Michel Frudit,Jeyaraj D Pandian,Anirudh Kulkarni,Yoshiki Yagita,Yohei Takenobu,Yuji Matsumaru,Satoshi Yamada,Ryuhei Kono,Takuya Kanamaru,Hidekazu Yamazaki,Manabu Sakaguchi,Kenichi Todo,Nobuaki Yamamoto,Kazutaka Sonoda,Tomoko Yoshida,Hiroyuki Hashimoto,Ichiro Nakahara,Elena A. Cora,David Volders,Célina Ducroux,Ashkan Shoamanesh,Johanna M. Ospel,Artem Kaliaev,Saima Ahmed,Umair Rashid,Leticia C Rebello,Vitor Mendes Pereira,Robert Fahed,Michael Chen,Sunil A Sheth,Lina Palaiodimou,Georgios Tsivgoulis,Ronil V. Chandra,Feliks Koyfman,Thomas W. Leung,Houman Khosravani,Sushrut Dharmadhikari,Giovanni Frisullo,Paolo Calabresi,Alexander Tsiskaridze,Nino Lobjanidze,Mikayel Grigoryan,Anna Członkowska,Diana Aguiar de Sousa,Jelle Demeestere,Conrad W Liang,Navdeep Sangha,Helmi L. Lutsep,Óscar Ayo-Martín,Antonio Cruz-Culebras,Anh D. Tran,Chang Y. Young,Charlotte Cordonnier,François Caparros,María Alonso de Leciñana,Blanca Fuentes,Dileep R. Yavagal,Tudor G Jovin,Laurent Spelle,Jacques Moret,Pooja Khatri,Osama O. Zaidat,Jean Raymond,Sheila Cristina Ouriques Martins,Thanh N. Nguyen +272 more
TL;DR: In this paper, the authors measured the global impact of the COVID-19 pandemic on the volumes of the volumes for medical care in the United Kingdom and the United States.
Journal ArticleDOI
Reductions in Hospital Admissions and Delays in Acute Stroke Care During the Pandemic of COVID-19.
TL;DR: Profound reductions in stroke hospital admissions and significant delays in emergency care for acute ischemic stroke occurred during the pandemic of COVID-19, and engagement and effective communication with all stakeholders including patients, health care providers, governmental policymakers, and other implementation partners are required for future success in similar crises.
Journal ArticleDOI
Immunosuppression in chronic autoimmune neurological disorders during the COVID-19 pandemic.
Sukanthi Kovvuru,Krishna Nalleballe,Sanjeeva Onteddu,Rohan Sharma,Madhu Jasti,Nidhi Kapoor,Karthika Veerapaneni,Sisira Yadala,Vasuki Dandu,Robert L. Archer,Richard Nowak,Bhaskar Roy +11 more
TL;DR: IT use does not appear to make patients with aNMD and MS more vulnerable to COVID-19, and it is important to consider individualizing immunotherapy regimens in some cases.
Journal ArticleDOI
Acute Encephalopathy Is Associated With Worse Outcomes In COVID-19 Patients.
TL;DR: Among hospitalized COVID-19 patients, acute encephalopathy is common and more likely to occur in patients with medical co-morbidities and are more likely than other patients to need critical care, intubation and have higher 30-day mortality even after adjusting for age and underlyingmedical co- Morbidities.
References
More filters
Journal ArticleDOI
Large-Vessel Stroke as a Presenting Feature of Covid-19 in the Young.
Thomas J Oxley,J Mocco,Shahram Majidi,Christopher P. Kellner,Hazem Shoirah,I. Paul Singh,Reade De Leacy,Tomoyoshi Shigematsu,Travis R. Ladner,Kurt A. Yaeger,Maryna Skliut,Jesse Weinberger,Neha S. Dangayach,Joshua B. Bederson,Stanley Tuhrim,Johanna T Fifi +15 more
TL;DR: Five patients younger than 50 years of age with large-vessel stroke and Covid-19 infection presented to a health system in New York City over a 2-week period with signs of stroke and infection.
Journal ArticleDOI
Reduced Rate of Hospital Admissions for ACS during Covid-19 Outbreak in Northern Italy.
Ovidio De Filippo,Fabrizio D'Ascenzo,Filippo Angelini,Pier Paolo Bocchino,Federico Conrotto,Andrea Saglietto,Gioel Gabrio Secco,Gianluca Campo,Guglielmo Gallone,Roberto Verardi,Luca Gaido,Mario Iannaccone,Marcello Galvani,Fabrizio Ugo,Umberto Barbero,Vincenzo Infantino,Luca Olivotti,Marco G. Mennuni,Sebastiano Gili,Fabio Infusino,Matteo Vercellino,Ottavio Zucchetti,Gianni Casella,Massimo Giammaria,Giacomo Boccuzzi,Paolo Tolomeo,Baldassarre Doronzo,Gaetano Senatore,Walter Grosso Marra,Andrea Rognoni,Daniela Trabattoni,Luca Franchin,Andrea Borin,Francesco Bruno,Alessandro Galluzzo,Alfonso Gambino,Annamaria Nicolino,Alessandra Truffa Giachet,Gennaro Sardella,Francesco Fedele,Silvia Monticone,Antonio Montefusco,Pierluigi Omedè,Mauro Pennone,Giuseppe Patti,Massimo Mancone,Gaetano M. De Ferrari +46 more
TL;DR: During the Covid-19 outbreak in northern Italy, the daily rate of admissions for acute coronary syndrome at 15 hospitals was significantly lower than in previous outbreaks.
Journal ArticleDOI
COVID-19 presenting as stroke.
Akshay Avula,Krishna Nalleballe,Naureen Narula,Steven Sapozhnikov,Vasuki Dandu,Sudhamshi Toom,Allison Glaser,Dany Elsayegh +7 more
TL;DR: Stroke teams should be wary of the fact that COVID-19 patients can present with cerebrovascular accidents and dawn appropriate personal protective equipment in every suspected patient.
Journal ArticleDOI
The Baffling Case of Ischemic Stroke Disappearance from the Casualty Department in the COVID-19 Era.
Nicola Morelli,Eugenia Rota,Chiara Terracciano,Paolo Immovilli,Marco Spallazzi,Davide Colombi,Domenica Zaino,Emanuele Michieletti,Donata Guidetti +8 more
TL;DR: A study investigates the monthly variance of ischemic stroke using the ANOVA test and finds that it seems to have almost disappeared from the Casualty Department.