Background: Stroke is a major global cause of death and disability. Most strokes occur in populations of low-middle income (LMIC); therefore, the subsequent disease burden is greater than in populations of high-income countries. Few epidemiological data exist for stroke in Latin America, composed primarily of LMIC. Aims: To determine epidemiological measures of incidence, prevalence, and 1-month case-fatality for stroke in Latin America/Caribbean (LAC) during 1997-2021. Summary of review: A structured search was conducted to identify relevant references from MEDLINE, WOS, and LILACS databases for prospective observational and cross-sectional studies in LAC populations from January 1997 to December 2021. 9,242 records were screened and 12 selected for analysis, seven incidence studies and five prevalence studies. Case-fatality rate was reported in six articles. Sub-group analysis by age, sex and income countries was performed. A narrative synthesis of the findings was performed. Meta-analysis was performed using random-effect model to obtain pooled estimates with 95% confidence intervals. Studies quality was assessed according to the risk of bias criteria described in the Joanna Briggs Institute’s guide. The overall crude annual incidence rate of first-ever stroke in LAC was 119.0 (95%CI 95.9-142.1)/100,000 people per year (with high heterogeneity between studies [I2= 98.1%]). The overall crude prevalence was 3,060 (95%CI 95.9-142.1)/100,000 people (with high heterogeneity between studies [I2= 98.8%]). The overall case-fatality rate at 1 month after the first stroke was 21.1% (95% CI 18.6-23.7) (I2=49.40%). Conclusion: This review contributes to our understanding regarding the burden caused by stroke in LAC. More studies with comparable designs are needed to generate reliable data and should include both standardised criteria such as the WHO clinical criteria and updated standard methods of case assurance, data collection and reporting.
<b><i>Background and Purpose:</i></b> Telemedicine for stroke patients’ care (telestroke [TS]) has grown notably in recent decades and may offer advantages during health crisis. Hospital admissions related to stroke have decreased globally during the COVID-19 pandemic, but scarce information is available regarding the effect of COVID-19 in TS. Using a population-based TS registry, we investigated the impact of the first year of the COVID-19 pandemic throughout our TS network in Santiago, Chile. <b><i>Methods:</i></b> Stroke codes evaluated after the onset of COVID-19 restrictions in Chile (defined as March 15, 2020) were compared with those evaluated in 2019. We analyzed differences between number of stroke codes, thrombolysis rate, stroke severity, and time from the stroke onset to hospital admission. <b><i>Results:</i></b> We observed that the number of stroke codes and the number of patients undergoing reperfusion therapy did not change significantly (<i>p</i> = 0.669 and 0.415, respectively). No differences were found with respect to the median time from the stroke onset to admission (<i>p</i> = 0.581) or in National Institutes of Health Stroke Scale (NIHSS) scores (<i>p</i> = 0.055). The decision-making-to-needle time was significantly shorter in the COVID-19 period (median 5 min [IQR 3–8], <i>p</i> < 0.016), but no significant changes were found at the other times. <b><i>Conclusions:</i></b> This study demonstrates the potential of adapting TS to extreme situations such as the COVID-19 pandemic, as well as the importance of establishing networks that facilitate patient access to quality treatments.
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