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Reduced Admissions for Cerebrovascular Events During COVID-19 Outbreak in Italy.
Sacco, Simona; Ricci, Stefano; Ornello, Raffaele; Eusebi, Paolo; Petraglia, Luca; Toni, Danilo.
  • Sacco S; Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Italy (S.S., R.O.).
  • Ricci S; Department of Neurology and Stroke Unit, USL Umbria 1, Gubbio and Città di Castello Hospital, Perugia, Italy (S.R.).
  • Ornello R; Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Italy (S.S., R.O.).
  • Eusebi P; Section of Neurology, Department of Medicine, University of Perugia, Italy (P.E.).
  • Petraglia L; Department of Human Neurosciences, Sapienza University of Rome, Italy (L.P., D.T.).
  • Toni D; Department of Human Neurosciences, Sapienza University of Rome, Italy (L.P., D.T.).
Stroke ; 51(12): 3746-3750, 2020 12.
Article in English | MEDLINE | ID: covidwho-1021185
ABSTRACT
BACKGROUND AND

PURPOSE:

We aimed to investigate the rate of hospital admissions for cerebrovascular events and of revascularization treatments for acute ischemic stroke in Italy during the coronavirus disease 2019 (COVID-19) outbreak.

METHODS:

The Italian Stroke Organization performed a multicenter study involving 93 Italian Stroke Units. We collected information on hospital admissions for cerebrovascular events from March 1 to March 31, 2020 (study period), and from March 1 to March 31, 2019 (control period).

RESULTS:

Ischemic strokes decreased from 2399 in 2019 to 1810 in 2020, with a corresponding hospitalization rate ratio (RR) of 0.75 ([95% CI, 0.71-0.80] P<0.001); intracerebral hemorrhages decreased from 400 to 322 (hospitalization RR, 0.81 [95% CI, 0.69-0.93]; P=0.004), and transient ischemic attacks decreased from 322 to 196 (hospitalization RR, 0.61 [95% CI, 0.51-0.73]; P<0.001). Hospitalizations decreased in Northern, Central, and Southern Italy. Intravenous thrombolyses decreased from 531 (22.1%) in 2019 to 345 in 2020 (19.1%; RR, 0.86 [95% CI, 0.75-0.99]; P=0.032), while primary endovascular procedures increased in Northern Italy (RR, 1.61 [95% CI, 1.13-2.32]; P=0.008). We found no correlation (P=0.517) between the hospitalization RRs for all strokes or transient ischemic attack and COVID-19 incidence in the different areas.

CONCLUSIONS:

Hospitalizations for stroke or transient ischemic attacks across Italy were reduced during the worst period of the COVID-19 outbreak. Intravenous thrombolytic treatments also decreased, while endovascular treatments remained unchanged and even increased in the area of maximum expression of the outbreak. Limited hospitalization of the less severe patients and delays in hospital admission, due to overcharge of the emergency system by COVID-19 patients, may explain these data.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombolytic Therapy / Cerebral Hemorrhage / Ischemic Attack, Transient / Thrombectomy / Ischemic Stroke / COVID-19 / Hospitalization Type of study: Experimental Studies / Observational study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Stroke Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombolytic Therapy / Cerebral Hemorrhage / Ischemic Attack, Transient / Thrombectomy / Ischemic Stroke / COVID-19 / Hospitalization Type of study: Experimental Studies / Observational study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Stroke Year: 2020 Document Type: Article