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COVID-19 and stroke: Experience in a Ghanaian healthcare system.
Sarfo, Fred S; Mensah, Naa Oboshie; Opoku, Francis Agyapong; Adusei-Mensah, Nathaniel; Ampofo, Michael; Ovbiagele, Bruce.
  • Sarfo FS; Department of Medicine, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana; Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana. Electronic address: stephensarfo78@gmail.com.
  • Mensah NO; Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
  • Opoku FA; Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
  • Adusei-Mensah N; Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
  • Ampofo M; Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
  • Ovbiagele B; Department of Neurology, University of California San Francisco, USA.
J Neurol Sci ; 416: 117044, 2020 09 15.
Article in English | MEDLINE | ID: covidwho-651242
ABSTRACT

BACKGROUND:

The novel coronavirus disease 19 (COVID-19) causes multi-system disease including possibly heightened stroke risk. Data from high-income countries (HIC) suggest disruptions to care delivery with reduced stroke admissions and administration of acute stroke reperfusion therapies. We are unaware of any published data on the impact of the COVID-19 pandemic on stroke admissions and outcomes in sub-Saharan Africa.

PURPOSE:

To compare rates of stroke admissions and case fatality between corresponding periods in 2020 and 2019, within a hospital system in Ghana, to assess the potential impact of the COVID-19 pandemic.

METHODS:

We compared monthly stroke admissions and mortality rates between January to June 2020 vs. January to June 2019 at the Komfo Anokye Teaching Hospital, a tertiary medical center in Ghana. Predictors of in-patient mortality were assessed using a multivariate logistic regression model.

RESULTS:

Stroke admissions were higher in January to June 2020 vs. January to June 2019 (431 vs. 401), an increase of +7.5% (95% CI 5.1-10.5%). There was also a rise in recurrent stroke admissions in 2020 vs. 2019 (19.0% vs. 10.9%, p = .0026). Stroke case fatality trended higher in 2020 vs. 2019 (29.3% vs. 24.2%, p = .095) with an adjusted odds ratio of 1.22 (95% CI 0.89-1.68).

CONCLUSION:

While an influence of secular trends cannot be excluded, the COVID-19 outbreak coincided with a comparatively significant rise in initial and recurrent stroke admissions at this Ghanaian tertiary hospital. Continued surveillance at this hospital, as well as assessment of this issue at other sites in Africa is warranted.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Admission / Stroke / COVID-19 Type of study: Observational study / Prognostic study Limits: Humans Country/Region as subject: Africa Language: English Journal: J Neurol Sci Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Admission / Stroke / COVID-19 Type of study: Observational study / Prognostic study Limits: Humans Country/Region as subject: Africa Language: English Journal: J Neurol Sci Year: 2020 Document Type: Article