Impact of the COVID-19 Pandemic on Stroke Subtype Presentation in Patients Without COVID-19 Infection.

Autor:	Sawicka KM; University of Toronto, Medicine, Division of Neurology, Toronto, Canada., Catanese L; Hamilton Health Sciences, McMaster University, Medicine (Neurology), Hamilton, Canada., Williams J; University Health Network, Toronto Western Hospital, University of Toronto, Division of Neurology, Toronto, Canada., Crellin L; University Health Network, Toronto Western Hospital, University of Toronto, Division of Neurology, Toronto, Canada., Francis T; University of Toronto, Toronto, Canada., Katsanos AH; Hamilton Health Sciences, McMaster University, Medicine (Neurology), Hamilton, Canada., Shoamanesh A; Hamilton Health Sciences, McMaster University, Medicine (Neurology), Hamilton, Canada., Chen J; McMaster University, Hamilton, Canada., Pikula A; University Health Network, Toronto Western Hospital, University of Toronto, Division of Neurology, Toronto, Canada., Schaafsma JD; University Health Network, Toronto Western Hospital, University of Toronto, Division of Neurology, Toronto, Canada.
Jazyk:	angličtina
Zdroj:	The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques [Can J Neurol Sci] 2024 Jan; Vol. 51 (1), pp. 78-86. Date of Electronic Publication: 2023 Jan 30.
DOI:	10.1017/cjn.2023.19
Abstrakt:	Background & Aims: It is unknown if the COVID-19 pandemic and public health measures had an immediate impact on stroke subtypes and etiologies in patients not infected with COVID-19. We aimed to evaluate if the proportion of non-COVID-19-related stroke subtypes (ischemic vs. hemorrhagic) and etiologies (cardioembolic, atherosclerosis, small vessel disease, and others) during the pandemic's first wave were different from prepandemic. Methods: For this retrospective cohort study, we included patients without COVID-19 with ischemic or hemorrhagic stroke at two large Canadian stroke centers between March-May 2019 (prepandemic cohort) and March-May 2020 (pandemic cohort). Proportions of stroke subtypes and etiologies were compared between cohorts using chi-square tests. Results: The prepandemic cohort consisted of 234 stroke patients and the pandemic cohort of 207 stroke patients. There were no major differences in baseline characteristics. The proportions of ischemic versus hemorrhagic stroke were similar (ischemic stroke: 77% prepandemic vs. 75% pandemic; hemorrhagic stroke:12% prepandemic vs. 14% pandemic; p > 0.05). There were no differences in etiologies, except for a decreased proportion of ischemic stroke due to atherosclerosis in the pandemic cohort (26% prepandemic vs. 15% pandemic; difference: 10.6%, 95%CI: 1.4-19.7; p = 0.03). Notably, during the pandemic, the cause of ischemic stroke was more often unknown because of incomplete work-up (13.3% prepandemic vs. 28.2% pandemic, difference: 14.9%, 95%-CI: 5.7-24.2; p = <0.01). Conclusions: In this study, the pandemic had no clear effect on stroke subtypes and etiologies suggesting a limited impact of the pandemic on stroke triggers. However, the shift from atherosclerosis toward other causes warrants further exploration.
Databáze:	MEDLINE
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