Cross-sectional case-control studies (Blue)
This nationwide study assessed the impact of the pandemic on stroke hospitalisation rates, patient characteristics, and 30‐day case fatality rates. In particular all hospitalisations for stroke from January to June of each year from 2017 to 2020 were selected using ICD‐10 codes I60 to I64 in the national hospital discharge database. Patient characteristics and management were described according to three time periods: pre‐lockdown, lockdown, and post‐lockdown. Weekly incidence rate ratios (IRRs) were computed to compare time trends in the rates of patients hospitalised for stroke as well as in‐hospital and 30‐day case fatality rates between 2017‐2019 and 2020. In 2020, between weeks 1 and 24, 55,308 patients were hospitalised for stroke in France. IRRs decreased by up to 30% for all age groups, sex, and stroke types during the lockdown compared to 2017‐2019. Patients hospitalised during the second and third weeks of the lockdown had higher in‐hospital case fatality rates compared to 2017‐2019. In‐hospital case fatality rates increased by almost 60% in patients under 65 years. Out‐of‐hospital 30‐day case fatality rates increased between weeks 11 and 15 among patients who returned home after their hospitalisation. Important changes in care management were found, including fewer stroke patients admitted to resuscitation units, more admitted to stroke care units, and a shorter mean length of hospitalisation. The authors concluded that during the first weeks of the lockdown, rates of patients hospitalized for stroke felt down by 30% along with substantial increases of both in‐hospital and out‐of‐hospital 30‐day case‐fatality rates.
Amélie Gabet et al., Impact of the COVID‐19 pandemic and a national lockdown on hospitalisation for stroke and related 30‐day mortality in France: a nationwide observational study. European Journal of Neurology. https://doi.org/10.1111/ene.14831