COVID-19 Lockdown Effects on Acute Stroke Care in Latin America

Pujol-Lereis, Virginia; Flores, Alan; Barboza, Miguel A; Abanto, Carlos; Amaya, Pablo; Bayona, Hernán; Bonardo, Pablo; Diaz-Escobar, Luis; Gómez-Schneider, Maia; Góngora‐Rivera, Fernando; Lavados, Pablo M.; León, Carolina Ponce de; Luraschi, A.; Márquez-Romero, Juan Manuel; Ouriques-Martins, Sheila C; Navia, Victor; Ruíz-Franco, Angélica; Vences, Miguel A.; Zurrú, María Cristina; Araúz, Antonio; Ameriso, Sebastián F.

doi:10.1016/j.jstrokecerebrovasdis.2021.105985

Cited by 16 publications

(13 citation statements)

References 15 publications

(17 reference statements)

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Section: Discussionmentioning

confidence: 99%

“…10 In addition, a multinational study comprising 7 countries and 18 centers in Latin America showed that there was a mild decrease in admissions of ischemic stroke during the COVID-19 lockdown period (March-June 2020) compared to the same period in 2019, with a significant delay in time to consultations and worse hospitalization outcomes. 11 Government instructions involving stay-at-home, lockdown, curfew, and social distancing policies have proved effective in combating the COVID-19 dissemination. [12][13][14] However, social distancing during the COVID-19 period lockdown may also play a central role in the delays of ischemic stroke patient referrals and escalated treatment to tertiary centers.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Impact of COVID-19 Pandemic on Ischemic Stroke Patients in a Comprehensive Hospital

Chen¹,

Nguyen²,

Siegler³

et al. 2022

RMHP

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Purpose This study aimed to investigate the impact of characteristic ischemic stroke and outcomes during the first COVID-19 pandemic lockdown. Patients and Methods A retrospective, observational cohort study of a comprehensive tertiary stroke center was conducted. Patients with ischemic stroke were divided into pre-COVID-19 lockdown (11/1/2019 to 1/30/2020) and COVID-19 lockdown (1/31/2020 to 4/30/2020) period groups. Patient data on stroke admission, thrombolysis, endovascular treatment, and 3-month routine follow-up were recorded. Data analysis was performed using SPSS according to values following a Gaussian distribution. Results The pre-COVID-19 lockdown period group comprised 230 patients compared to 215 patients in the COVID-19 lockdown period group. Atrial fibrillation was more predominant in the COVID-19 lockdown period group (11.68% vs 5.65%, p=0.02) alongside patients who were currently smoking (38.8% vs 28.7%, p=0.02) and drinking alcohol (30.37% vs 20.00%, p=0.012) compared with that of the pre-COVID-19 lockdown period group. For patients receiving thrombolysis, the median door-to-CT time was longer in the COVID-19 lockdown period group (17.0 min (13.0, 24.0) vs 12.0 min (8.0, 17.3), p=0.012), median door to needle time was 48.0 minutes (35.5, 73.0) vs 43.5 minutes (38.0, 53.3), p=0.50, compared with that of the pre-COVID-19 lockdown period group. There were no differences for patients receiving mechanical thrombectomy. The median length of hospitalization (IQR) was no different. Discharge mRS scores (IQR) were higher in the COVID-19 lockdown period group (1.0 (1.0, 3.0) vs 1.0 (1.0, 2.0), p=0.022). Compared with the pre-COVID-19 lockdown period, hospitalization cost (Chinese Yuan) in the COVID-19 period group was higher (13,445.7 (11,009.7, 20,030.5) vs 10,799.2 (8692.4, 16,381.7), p=0.000). There was no difference observed in 3-month mRS scores. Conclusion Patients presenting with ischemic stroke during the COVID-19 pandemic lockdown period had longer median door-to-CT time and higher hospitalization costs. There were no significant differences in 3-month outcomes. Multidisciplinary collaboration and continuous workflow optimization may maintain stroke care during the COVID-19 pandemic lockdown.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Impact of COVID-19 Pandemic on Ischemic Stroke Patients in a Comprehensive Hospital

Chen¹,

Nguyen²,

Siegler³

et al. 2022

RMHP

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“…Furthermore, the study evidenced a substantial increase in the proportion of stroke admissions beyond 48 h from symptoms onset. Therefore, it is possible that the delay in diagnosis and treatment of stroke, demonstrated by a larger time to consultation during lockdown period, may have contributed to an increase in mortality [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Stroke Hospital Admissions during the COVID-19 Outbreak in São Paulo, Brazil

et al. 2022

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Background: Globally, stroke remains an important cause of death and long-term disability, and the impact of coronavirus disease (COVID-19) on the health system may have impaired stroke care. Previous studies suggest significant reduction in hospital admissions for stroke after COVID-19 onset as patients may hesitate seeking medical help due to fear of exposure. Methods: This cross-sectional study included cases of hospital admissions for stroke, identified from the Hospital Information System of the Unified Health System (Sistema Único de Saúde), which contains official and public data in Brazil. Data were collected in duplicate, then categorized according to the International Classification of Diseases, tenth revision (ICD-10), considering codes I60–I69. Linear regression was used to estimate the variation in hospital admissions for stroke in the city of São Paulo (SP) – the largest and most populous city in Brazil and Latin America, between January and June of each analyzed year (2017–2020). The percentage variation between June and January 2020 was also compared. The level of significance was set at 5%, and the statistical program used was Stata, version 14.0. Results: In the city of SP, during the first wave of COVID-19, from January to June 2020, there were registered decreases in absolute numbers and mean monthly admissions for stroke. Compared to January 2020, data from June 2020 showed 17% reduction in hospitalizations for intracerebral hemorrhage, 32% for cerebral infarction, 26% for stroke unspecified, and 47% for other cerebrovascular diseases. Conclusion: We argue for policies aimed at improving stroke care and developing awareness campaigns regarding the importance of early diagnosis and treatment, as even in less severe presentations, stroke can trigger an increase in mortality, cost, and long-term disability.

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“…Regarding public health data in Latin America, there has been a decrease in non-COVID-19–related healthcare during lockdown. This includes the suspension of nontransmissible diseases and mental health primary care services 19 and a reduction in stroke consultations in emergency rooms, 20 together with decreases in cancer screening tests and therapies (chemotherapy and oncologic surgery). 21…”

Section: Covid-19 Pandemic In Latin America: Effects Of Poverty and S...mentioning

confidence: 99%

Impact of a National Multicentric Strategy to Support Kidney Transplant Patients During the COVID-19 Pandemic in Latin America: FUTAC Team Creation and Activities

Pefaur¹,

Toro²,

Lorca³

et al. 2021

Transplantation

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Around the World J.P. was the first head of the FUTAC division of kidney transplant patients; they participated in the research design, performance of research, and writing of the article. L.T. was responsible for the kidney transplant and dialysis patients FUTAC registry; they participated in the research design, performance of research, data analysis, and writing of the article. E.L. is the current head of the FUTAC team; they participated in the research design, data analysis, and writing of the article. R.T. created the FUTAC team and was a past president of the Chilean Society of Nephrology; they participated in the research design and writing of the article.

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COVID-19 Lockdown Effects on Acute Stroke Care in Latin America

Cited by 16 publications

References 15 publications

The Impact of COVID-19 Pandemic on Ischemic Stroke Patients in a Comprehensive Hospital

The Impact of COVID-19 Pandemic on Ischemic Stroke Patients in a Comprehensive Hospital

Stroke Hospital Admissions during the COVID-19 Outbreak in São Paulo, Brazil

Impact of a National Multicentric Strategy to Support Kidney Transplant Patients During the COVID-19 Pandemic in Latin America: FUTAC Team Creation and Activities

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