Impact of the corona virus (Covid 19)pandemic on stroke code activities and outcome. A retrospective observational study

Abstract

Abstract Background The Coronavirus 2019 (COVID-19) pandemic has affected the delivery of healthcare around the world. We assessed the impact of the COVID-19 pandemic on hospital presentations, reperfusion treatment and outcomes in a comprehensive stroke centre. Methods In this observational study seven months of retrospective data from February 2020 (at the beginning of the pandemic) were compared to data collected for the same time frame in 2019. Results There was a transient reduction in stroke presentation only at the beginning of the wave of COVID-19 community transmissions in Sydney. There were significantly more haemorrhagic strokes in the COVID-19 period (n = 66, 15.4 % vs n = 95, 21.5 %, P = 0.02) and baseline stroke severity was higher (NIHSS median 3 vs 4, P = 0.049). Similar proportions of ischaemic stroke patients received reperfusion therapy in the two time periods (IV thrombolysis [n = 51, 17.3% vs n = 52, 17.9%, P = 0.838]; and ECR [n = 38, 12.9% vs n = 46, 15.9%, P = 0.30]). The time from presentation to stroke bed admission was significantly shorter during the COVID-19 period (median 295 vs 260 minutes, P = 0.031). Three-month follow-up Modified Rankin Score was 2 (median) in both periods (P = 0.92). Conclusion There was no change in stroke presentations overall during the 2020 COVID 19 pandemic time period with the exception of the first phase of the pandemic. Baseline stroke severity scores were higher. There was no a difference in the degree of disability at three-month follow-up.