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Delays in Presentation Time Under the COVID-19 Epidemic in Patients With Transient Ischemic Attack and Mild Stroke: A Retrospective Study of Three Hospitals in a Japanese Prefecture.
Tanaka, Koji; Matsumoto, Shoji; Nakazawa, Yusuke; Yamada, Takeshi; Sonoda, Kazutaka; Nagano, Sukehisa; Hatano, Taketo; Yamasaki, Ryo; Nakahara, Ichiro; Isobe, Noriko.
  • Tanaka K; Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
  • Matsumoto S; Department of Comprehensive Strokology, Fujita Health University School of Medicine, Toyoake, Japan.
  • Nakazawa Y; Department of Neurosurgery, Kokura Memorial Hospital, Kitakyushu, Japan.
  • Yamada T; Department of Neurology, Murakami Karindoh Hospital, Fukuoka, Japan.
  • Sonoda K; Department of Neurology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan.
  • Nagano S; Department of Neurology, Fukuoka City Hospital, Fukuoka, Japan.
  • Hatano T; Department of Neurosurgery, Kokura Memorial Hospital, Kitakyushu, Japan.
  • Yamasaki R; Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
  • Nakahara I; Department of Comprehensive Strokology, Fujita Health University School of Medicine, Toyoake, Japan.
  • Isobe N; Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Front Neurol ; 12: 748316, 2021.
Article in English | MEDLINE | ID: covidwho-1518508
ABSTRACT

Background:

Coronavirus Disease 2019 (COVID-19) has spread worldwide with collateral damage and therefore might affect the behavior of stroke patients with mild symptoms seeking medical attention.

Methods:

Patients with ischemic stroke who were admitted to hospitals within 7 days of onset were retrospectively registered. The clinical characteristics, including onset-to-door time (ODT), of patients with a transient ischemic attack (TIA)/mild stroke (National Institutes of Health Stroke Scale [NIHSS] score of ≤ 3 on admission) or moderate/severe stroke were compared between those admitted from April 2019 to March 2020 (pre-COVID-19 period) and from April to September 2020 (COVID-19 period). Multivariable regression analysis was performed to identify factors associated with the ODT.

Results:

Of 1,100 patients (732 men, median age, 73 years), 754 were admitted during the pre-COVID-19 period, and 346 were admitted during the COVID-19 period. The number and proportion of patients with TIA/minor stroke were 464 (61.5%) in the pre-COVID-19 period and 216 (62.4%) during the COVID-19 period. Among patients with TIA/mild stroke, the ODT was longer in patients admitted during the COVID-19 period compared with that of the pre-COVID-19 period (median 864 min vs. 508 min, p = 0.003). Multivariable analysis revealed the COVID-19 period of admission was associated with longer ODT (standardized partial regression coefficient 0.09, p = 0.003) after adjustment for age, sex, route of arrival, NIHSS score on admission, and the presence of hypertension, diabetes mellitus, and wake-up stroke. No significant change in the ODT was seen in patients with moderate/severe stroke.

Conclusions:

The COVID-19 epidemic might increase the ODT of patients with TIA/mild stroke.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Topics: Long Covid Language: English Journal: Front Neurol Year: 2021 Document Type: Article Affiliation country: Fneur.2021.748316

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Topics: Long Covid Language: English Journal: Front Neurol Year: 2021 Document Type: Article Affiliation country: Fneur.2021.748316