Changes in the Care of Neurological Diseases During the First Wave of the COVID-19 Pandemic: A Single Private Center Study in Argentina

Abstract

Introduction: Healthcare systems are struggling to cope with the rapid evolution of the COVID-19 pandemic. In Argentina, the pandemic is advancing despite prolonged lockdown measures. We aim to analyze the impact of the easing of lockdown measures in the number of visits to the emergency department (ED), and outpatient consultations (OC) to a tertiary neurological center.Methods: We compared the number of ED visits with the social mobility overtime. We also compared the number of OC, and the geographic distribution of patients' addresses between 2019 and 2020.Results: ED visits decreased 48.33% (n = 14,697 in 2019 vs. n = 7,595 in 2020). At the beginning of the lockdown, the social mobility decreased in pharmacies/groceries, and workplaces, along with a reduction in the number of ED visits. With the easing of lockdown restrictions, the social mobility decreased in residential places, slightly increased in workplaces and almost return to normal in pharmacies/groceries. Variations in ED visits correlate better with social mobility in workplaces (coef. =0.75, p < 0.001) than in groceries/pharmacies (coef. =0.68, p < 0.001). OC decreased 43%. Fourteen percent of OC were tele consults. This was associated with an increase of the geographical area of influence of our center (standard distance of 109 km in 2019 and 127 km in 2020).Conclusions: Despite an increase in social mobility, the number of ED visits and OC to an Argentinian tertiary neurological center remain worrisomely low. The pandemic catalyzed the introduction of telemedicine in our country. This has also allowed patients from distant zones to gain access to specialized neurological care.

Telemedicine impact on post-stroke outpatient follow-up in an academic healthcare network during the COVID-19 pandemic

“… 5 , 6 Telemedicine provides an alternative strategy to evaluate and treat patients after discharge. 7 Understanding patient characteristics to identify those less likely to follow-up after discharge is important to design targeted interventions and increase follow-up rates.…”

Consecuencias Neurológicas y Psiquiátricas a largo plazo (6 meses) en pacientes con COVID leve de la comunidad.

“…Las complicaciones médicas durante la pandemia se produjeron por la infección del propio virus, por la insuficiente atención de otras patologías no-COVID y por el impacto del propio aislamiento social prolongado (Allegri et al, 2020;Dos Santos et al, 2021;Cohen et al, 2020a;Cohen et al, 2020b;Calandri et al, 2020;Calandri et al, 2021). Esas complicaciones fueron clasificadas en agudas aquellas que se daban durante el episodio infeccioso y sub agudas o crónicas las posteriores.…”