ABSTRACT
Background and aims: To observe how the Covid-19 pandemic affected trends in referrals to our tertiary hyperacute stroke unit (HASU). Methods: Referrals from emergency departments in hospitals within our sector were made electronically using the online 'Refer-A-Patient' system. We reviewed 150 referrals made post-Covid, from 16th March 2020 (when Covid restrictions were first introduced in the UK) until June 2020. These were compared with 150 referrals made pre-Covid, between March and June in 2019. Results: The patients in the pre-Covid referral cohort were significantly older on average than the post-Covid referral cohort (p=0.0476);there were more referrals under the age of 50, and fewer over the age of 80, post-Covid. We accepted significantly fewer patients for transfer post-Covid compared with pre-Covid (21% vs. 43% respectively, p=0.0001). The percentage of cases with a confirmed stroke diagnosis post-transfer was marginally higher post-Covid than pre-Covid (69% vs. 59% respectively, p=0.2443). Importantly, of the patients not accepted for transfer post-Covid, none had a subsequent stroke diagnosis. Conclusions: The Covid-19 pandemic seems to have led to a more selective approach in accepting referrals for transfer. This in turn appears to have reduced our stroke mimic rate. This poses an argument that there are benefits in being more selective. Video triage is an emerging tool, which can be used in emergency departments to aid the accuracy of selection for transfer and warrants further evaluation.