by Francesco Cavallieri and Marialuisa Zedde
For January 2023, we have selected Sedova P, Kent JA, Bryndziar T, Jarkovsky J, Tomek A, Sramek M, Skoda O, Sramkova T, Pokorová K, Littnerova S, Brown RD, Mikulik R. The decline in stroke hospitalization due to COVID-19 is unrelated to COVID-19 intensity, Eur J Neurol. 2022 Dec 13. doi: 10.1111/ene.15664.
During the COVID-19 pandemic many countries reported a decline in stroke hospitalization volumes. The aim of this study was to analyze whether this decline in the Czech Republic was related to the intensity of the COVID-19 pandemic.
Our authors of the month obtained data on incidence of all stroke subtypes in the Czech Republic from the National Register of Reimbursed Health Services for the years 2019, 2020 and 2021. Only patients diagnosed with subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH) and acute ischaemic stroke (AIS) (International Classification of Diseases, 10th revision, codes I60, I61 and I63, respectively) were included in the study. Door-to-needle time (DNT), onset-to-door time (ODT), and NIHSS at admission were obtained from the Registry of Stroke Care Quality.
The occurrence of each stroke type, the utilization of recanalization procedures (IVT, MT) and demographic parameters (age, sex) during the first pandemic year (1 March 2020 to 28 February 2021), overall and during the three COVID-19 waves within that year, were compared with the preceding year (1 March 2019 to 29 February 2020).
During the pandemic year as compared to the preceding year there were 26,453 vs 28,771 stroke admissions, representing an 8.8% decline (p<0.001). The decline (-10%, -11%, -19%) appeared in all COVID-19 waves (spring 2020, autumn 2020, winter 2021), except for an increase (2%) during summer 2020. Admissions for AIS declined by 10.2%, p<0.001), while haemorrhagic stroke volumes were minimally decreased. The absolute volumes of IVT and MT decreased by 9.4% (p<0.001) and 5.7% (p=0.16), respectively. However, the proportions of ischaemic stroke patients receiving IVT (18% vs 18%; p=0.72) and MT (6% vs 6%; p=0.28) remained unchanged. The authors concluded that there was a decline in stroke admissions, but such decline was not related to COVID-19 incidence. The frequency of use of recanalisation procedures (IVT, MT) and times (ODT, DNT) in AIS were preserved in the Czech Republic during the first year of the pandemic.