Kevin John John1, Rhea Anne Roy2, Bincy Baby3, Deep P. Pillai4, Anilkumar Sivan5, Joban John6, Sujin Koshy7, John K. John8
BACKGROUND
COVID-19 is associated with a hypercoagulable state and stroke is one of its most
common neurological complications. The current study is aimed at investigating
the effect of the COVID-19 pandemic on hospital admissions for stroke.
METHODS
We conducted a retrospective observational study to determine if there was a
significant difference in the number of hospital admissions for stroke during the 2
months of lockdown and the two preceding months, (starting on 24 March 2020).
The numbers were also compared with the figures during the same months in the
previous year. The numbers were also compared to the same months one year
prior. The secondary objectives were to compare the time between the onset of
stroke and presentation to the hospital, type of strokes that presented to the
hospital, severity of stroke, number of code activations, number of thrombolysis
conducted, and in-hospital mortality between the same time periods.
RESULTS
The total number of patients admitted for stroke during the time periods from 25th
March 2019 to 24th May 2019, 25th January 2020 to 24th March 2020 and 25th
March 2020 to 24th May 2020 were 82, 72 and 75 respectively, and there was no
statistically significant difference between these numbers. However, there was a
significant increase in the proportion of stroke cases when compared to total
hospital admissions. This suggests that an increase in stroke incidence may have
been masked by a reduction in the total number of patients presenting to the
hospital. The National Institutes of Health Stroke Scale (NIHSS) score of the
patients who presented during the lockdown were higher. There were no
significant differences in the time between the onset of stroke and presentation to
the hospital, type of strokes that presented to the hospital, severity of stroke,
number of code activations, number of thrombolysis conducted, and in-hospital
mortality between the periods under study.
CONCLUSIONS
The present study suggests that there may be a relative increase in the incidence
of stroke in the community, as a result of the COVID-19 pandemic. The patients
who presented with stroke during the lockdown period had a higher NIHSS score.
