Effects of COVID-19 pandemic in relation to stroke: Did the pandemic really change everything? A pre-post COVID-19 comparative study with literature review

Introduction and objectives: Ischemic stroke is the third leading cause of death and the first cause of disability in the world. Since March 2020, the COVID-19 pandemic has generated changes in daily medical practice, as well as an impact on access to health centers. The objective of this study is to evaluate the effect of the COVID-19 pandemic on the number of admissions, consultation time and treatment rates of stroke in our center. Material(s) and Method(s): Descriptive and retrospective study, with 115 patients between March 2019 and March 2021. Clinical characteristics, admissions time, severity and treatment rates pre-pandemic and during the same were compared. Result(s): Both groups presented mild events (71% vs. 59%, P > .05). There was an increase in the time from consultation to initiation of thrombolysis therapy during the pandemic (median 2.1 vs. 3.5 h, P = .02). No significant differences were observed in reperfusion rates, consultation time and door-to-needle time. Conclusion(s): In our study, a significant difference was observed between the time of symptom onset and treatment with thrombolysis during the pandemic. On the other hand, no significant differences were observed in relation to the number of admissions, consultation time and door-to-needle time or treatment rate of patients with stroke during the COVID-19 pandemic. We believe that this work can provide an approach to epidemiology in the private regional setting and a potential basis for further analysis of the collateral damage and long-term consequences generated by the COVID-19 pandemic. Copyright © 2022 Sociedad Neurologica Argentina

Registry of neurological manifestations due to coronavirus-19 (COVID-19)

COVID-19 disease has spread around the world since December 2019. Neurological symptoms are part of its clinical spectrum. Objective: To know the neurological manifestations in patients infected by COVID-19 in Argentina. Methods: Multicenter study conducted in adults, from May 2020 to January 2021, with confirmed COVID-19 and neurological symptoms. Demographic variables, existence of systemic or neurological comorbidities, the form of onset of the infection, alteration in complementary studies and the degree of severity of neurological symptoms were recorded. Results: 817 patients from all over the country were included, 52% male, mean age 38 years, most of them without comorbidities or previous neurological pathology. The first symptom of the infection was neurological in 56.2% of the cases, predominantly headache (69%), then anosmia/ageusia (66%). Myalgias (52%), allodynia/hyperalgesia (18%), and asthenia (6%) were also reported. 3.2% showed diffuse CNS involvement such as encephalopathy or seizures. 1.7% had cerebrovascular complications. Sleep disorders were observed in 3.2%. 6 patients were reported with Guillain Barré (GBS), peripheral neuropathy (3.4%), tongue paresthesia (0.6%), hearing loss (0.4%), plexopathy (0.3%). The severity of neurological symptoms was correlated with age and the existence of comorbidities. Conclusions: Our results, similar to those of other countries, show two types of neurological symptoms associated with COVID-19: some potentially disabling or fatal such as GBS or encephalitis, and others less devastating, but more frequent such as headache or anosmia that demand increasingly long-term care.