The first year of the Covid-19 pandemic saw fewer hospital visits for stroke, fewer therapies, more treatment delays and a higher risk of in-hospital delays in subsequent waves, according to a study from Canada.
Dr. Aravind Ganesh, University of Calgary, Calgary, Alberta, with coauthors, said:
“It is unlikely that the observed reductions in patients presenting to hospital with stroke reflect true declines in stroke occurrence, and more likely that it reflects pandemic-related hospital avoidance, as reported for other emergencies.”
Researchers analysed data on 19,531 patients in Alberta between January 1, 2016 and February 27, 2020 before the pandemic and 4,900 patients across the five pandemic phases from February 28, 2020, to March 31, 2021.
World Health Organization (WHO) data showed that ischemic stroke admissions decreased in Wave 1 compared to the pre-pandemic period, rebounded slightly before Wave 2 and declined again in Wave 3.
Treatments such as thrombolysis and endovascular therapy also declined from pre-pandemic levels.
As the coronavirus is associated with subsequent cardiovascular issues, the researchers expected to have seen more cases of strokes and heart attacks during the later waves.
However, the authors did note a substantial increase in out-of-hospital stroke deaths as a proportion of all stroke deaths during the pandemic period.
The study provides further evidence of the impact of the pandemic on medical emergencies such as stroke.
Data from Spain showed that admissions for myocardial infarction and stroke decreased by at least 40 per cent while preliminary research from Spain showed a 25 per cent drop.
The authors wrote:
“We have shown not only that the early COVID-19 pandemic was associated with decline in presentations for ischemic stroke and use of acute therapies, even after adjustment for confounding variables, but that these problems persisted in later waves.
“Importantly, the lower population-level incidence of thrombolysis and endovascular therapy appeared to reflect declines in stroke presentations rather than any therapeutic inertia.”
Nearly a third of people in the UK who survived a stroke between March and June 2020 said they delayed seeking treatment due to Covid.
The Stroke Association’s Recoveries at Risk report found that stroke patients were concerned about catching the virus or being a burden on the NHS.
