Stroke profile and care during the COVID-19 pandemic: What changed and what did not? A prospective cohort from Joinville, Brazil.

Autor:	Dos Reis FI; Division of Neurology, University of Joinville's Region, Joinville, Santa Catarina, Brazil., de Magalhães PSC; Division of Neurology, Hospital Municipal São José, Joinville, Santa Catarina, Brazil., Diegoli H; Division of Neurology, Hospital Municipal São José, Joinville, Santa Catarina, Brazil., Longo AL; Division of Neurology, Hospital Municipal São José, Joinville, Santa Catarina, Brazil., Moro CHC; Division of Neurology, Hospital Municipal São José, Joinville, Santa Catarina, Brazil., Safanelli JA; Hospital Municipal São José, Joinville Stroke Registry, Joinville, Santa Catarina, Brazil., Nagel V; Hospital Municipal São José, Joinville Stroke Registry, Joinville, Santa Catarina, Brazil., Lange MC; Federal University of Paraná, Hospital de Clínicas, Curitiba, Paraná, Brazil., Zétola VF; Federal University of Paraná, Hospital de Clínicas, Curitiba, Paraná, Brazil.
Jazyk:	angličtina
Zdroj:	Frontiers in neurology [Front Neurol] 2023 Feb 16; Vol. 14, pp. 1122875. Date of Electronic Publication: 2023 Feb 16 (Print Publication: 2023).
DOI:	10.3389/fneur.2023.1122875
Abstrakt:	Introduction: The COVID-19 pandemic has wrought negative consequences concerning quality of care for stroke patients since its onset. Prospective population-based data about stroke care in the pandemic are limited. This study aims to investigate the impact of COVID-19 pandemic on stroke profile and care in Joinville, Brazil. Methods: A prospective population-based cohort enrolled the first-ever cerebrovascular events in Joinville, Brazil, and a comparative analyzes was conducted between the first 12 months following COVID-19 restrictions (starting March 2020) and the 12 months just before. Patients with transient ischemic attack (TIA) or stroke had their profiles, incidences, subtypes, severity, access to reperfusion therapy, in-hospital stay, complementary investigation, and mortality compared. Results: The profiles of TIA/stroke patients in both periods were similar, with no differences in gender, age, severity, or comorbidities. There was a reduction in incidence of TIA (32.8%; p = 0.003). In both periods, intravenous thrombolysis (IV) and mechanical thrombectomy (MT) rates and intervals from door to IV/MT were similar. Patients with cardioembolic stroke and atrial fibrillation had their in-hospital stay abbreviated. The etiologic investigation was similar before and during the pandemic, but there were increases in cranial tomographies ( p = 0.02), transthoracic echocardiograms ( p = 0.001), chest X-rays ( p < 0.001) and transcranial Doppler ultrasounds ( p < 0.001). The number of cranial magnetic resonance imaging decreased in the pandemic. In-hospital mortality did not change. Discussion: The COVID-19 pandemic is associated with a reduction in TIA, without any influence on stroke profile, the quality of stroke care, in-hospital investigation or mortality. Our findings show an effective response by the local stroke care system and offer convincing evidence that interdisciplinary efforts are the ideal approach to avoiding the COVID-19 pandemic's negative effects, even with scarce resources. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 dos Reis, de Magalhães, Diegoli, Longo, Moro, Safanelli, Nagel, Lange and Zétola.)
Databáze:	MEDLINE
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