ABSTRACT
This study aimed to evaluate the behavioral and disease-related characteristics of patients with acute stroke during the Coronavirus disease (COVID-19) pandemic. This retrospective study was conducted using the Korean Stroke Registry database from a single cerebrovascular specialty hospital. We categorized the COVID-19 pandemic (February 2020 to June 2021) into three waves according to the number of COVID-19 cases recorded and the subjective fear index of the general population and matched them with the corresponding pre-COVID-19 (January 2019 to January 2020) periods. The total number of acute stroke hospitalizations during the pre-COVID-19 and COVID-19 periods was 402 and 379, respectively. The number of acute stroke hospitalizations recorded during the regional outbreak of COVID-19 was higher than that recorded during the corresponding pre-COVID-19 period (97 vs. 80). Length of hospital stay was significantly longer during the COVID-19 pandemic than during the pre-COVID-19 period (11.1 and 8.5 days, respectively; p = 0.003). There were no significant differences in the time from onset to hospital arrival, rate of acute intravenous/intra-arterial (IV/IA) treatments, and door-to-IV/IA times between the pre-COVID-19 and COVID-19 periods. This study suggests that specialty hospitals can effectively maintain the quality of healthcare through the management of acute time-dependent diseases, even during pandemics.
ABSTRACT
This study aimed to evaluate the behavioral and disease-related characteristics of patients with acute stroke during the Coronavirus disease (COVID-19) pandemic. This retrospective study was conducted using the Korean Stroke Registry database from a single cerebrovascular specialty hospital. We categorized the COVID-19 pandemic (February 2020 to June 2021) into three waves according to the number of COVID-19 cases recorded and the subjective fear index of the general population and matched them with the corresponding pre-COVID-19 (January 2019 to January 2020) periods. The total number of acute stroke hospitalizations during the pre-COVID-19 and COVID-19 periods was 402 and 379, respectively. The number of acute stroke hospitalizations recorded during the regional outbreak of COVID-19 was higher than that recorded during the corresponding pre-COVID-19 period (97 vs. 80). Length of hospital stay was significantly longer during the COVID-19 pandemic than during the pre-COVID-19 period (11.1 and 8.5 days, respectively;p = 0.003). There were no significant differences in the time from onset to hospital arrival, rate of acute intravenous/intra-arterial (IV/IA) treatments, and door-to-IV/IA times between the pre-COVID-19 and COVID-19 periods. This study suggests that specialty hospitals can effectively maintain the quality of healthcare through the management of acute time-dependent diseases, even during pandemics.
ABSTRACT
INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has led to changes in stroke patients' healthcare use. This study evaluated changes in Korean stroke patients' health-seeking behaviors and stroke care services using data from the Korean Stroke Registry (KSR). METHODS: We reviewed data from patients with acute stroke and transient ischemic attack (TIA) during 2019 (before COVID-19 period) and 2020 (COVID-19 period). Outcomes included patient characteristics, time from stroke onset to hospital arrival, and in-hospital stroke pathways. Subgroup analyses were performed for an epidemic region (Daegu city and Gyeongsangbuk-do region, the D-G region). RESULTS: The study included 1,792 patients from the pre-COVID-19 period and 1,555 patients from the COVID-19 period who visited hospitals that contribute to the KSR. During the COVID-19 period, the D-G region had two-thirds the number of cases (vs. the pre-CO-VID-19 period) and a significant decrease in the proportion of patients with TIA (9.97%-2.91%). Unlike other regions, the median onset-to-door time increased significantly in the D-G region (361 min vs. 526.5 min, p = 0.016), and longer onset-to-door times were common for patients with mild symptoms and who were in their 60s or 70s. The number of patients who underwent intravenous thrombolysis also decreased during the COVID-19 period, although the treatment times were not significantly different between the 2 periods. DISCUSSION/CONCLUSION: Korean stroke patients in a CO-VID-19 epidemic region exhibited distinct changes in health-seeking behaviors. Appropriate triage system and public education regarding the importance of early treatment are needed during the COVID-19 pandemic.