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The impact of home quarantine during COVID-19 lockdown on neurological hospitalizations, in-hospital mortality, and acute ischemic stroke management in older patients without COVID-19.
Haki, Cemile; Deniz, Olgun.
  • Haki C; Neurology Clinic, Bursa City Hospital, Bursa, Turkey.
  • Deniz O; Geriatric Medicine Clinic, Palliative Care Unit, Bursa City Hospital, Bursa, Turkey. Electronic address: olgundeniz2001@yahoo.com.
Clin Neurol Neurosurg ; 212: 107027, 2022 01.
Article in English | MEDLINE | ID: covidwho-1520782
ABSTRACT

INTRODUCTION:

This study aimed to investigate the impact of home quarantine in older patients without COVID-19 hospitalized due to neurological disorders.

METHODS:

We consecutively enrolled 255 elderly patients(median age 75 years, female 54%), including 180 (70%) in the pre-home quarantine period and 75 (30%) home quarantine period from January to May 2020 (ten weeks before and ten weeks after the March 21, 2020, lockdown for older patients in Turkey) in a tertiary referral neurological center.

RESULTS:

In the home quarantine period, we documented a fall in the number of neurological admissions by 58.3%, but an increased need for intensive care in older patients. Patients in the home quarantine period were younger [73 (65-91) vs 76 (65-95), p = 0.005], had worse Glasgow Coma Scores (12.3 ± 3.6 vs 13.7 ± 2.5, p = 0.007), higher in-hospital mortality rate (21.3% vs. 6.7%, p = 0.001), had a lower prevalence of comorbidities such as diabetes mellitus, hypertension, and cardiovascular disease, and chronic neurologic disease, albeit had a higher prevalence of the acute cerebrovascular disease (hemorrhagic/ ischemic stroke)(90.7% vs 78.9, p = 0.025). In this period, even there was an increase in the proportion of the patients undergoing reperfusion therapy, it wasn't statistically significant (20.3% vs. 10.1%, p 0.054). Multivariate analysis revealed that high NIHSS (The National Institutes of Health Stroke Scale) score (OR=1.25; p < 0.001) and hospitalization in the home quarantine period (OR=3.21; p = 0.043) were independently associated with in-hospital mortality.

CONCLUSION:

Our study indicated that during the COVID-19 home quarantine period, despite a significantly fewer number of patients admitted to the hospitalization, there was a higher percentage of those hospitalized needing intensive care and an overall worse prognosis.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Quarantine / Ischemic Stroke / COVID-19 / Hospitalization Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male Country/Region as subject: Asia Language: English Journal: Clin Neurol Neurosurg Year: 2022 Document Type: Article Affiliation country: J.clineuro.2021.107027

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Quarantine / Ischemic Stroke / COVID-19 / Hospitalization Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male Country/Region as subject: Asia Language: English Journal: Clin Neurol Neurosurg Year: 2022 Document Type: Article Affiliation country: J.clineuro.2021.107027