TY - JOUR
T1 - Decrease in stroke diagnoses during the COVID-19 pandemic
T2 - Where did all our stroke patients go?
AU - Dula, Adrienne Nicole
AU - Brown, Gretchel Gealogo
AU - Aggarwal, Aarushi
AU - Clark, Kal L.
N1 - Publisher Copyright:
© Adrienne Nicole Dula, Gretchel Gealogo Brown, Aarushi Aggarwal, Kal L Clark. Originally published in JMIR Aging (http://aging.jmir.org), 21.10.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/)
PY - 2020/7
Y1 - 2020/7
N2 - Despite the evidence suggesting a high rate of cerebrovascular complications in patients with SARS-CoV-2, reports have indicated decreasing rates of new ischemic stroke diagnoses during the COVID-19 pandemic. The observed decrease in emergency department (ED) visits is unsurprising during this major crisis, as patients are likely to prioritize avoiding exposure to SARS-CoV-2 over addressing what they may perceive as mild symptoms of headache, lethargy, difficulty speaking, and numbness. In the central and south Texas regions where we practice, we suspect that patient admission, treatment, and discharge volumes for acute stroke treatment have decreased significantly since COVID-19-related shelter-at-home orders were issued. Symptoms of stroke are frequently noticed by a family member, friend, or community member before they are recognized by the patients themselves, and these symptoms may be going unnoticed due to limited face-to-face encounters. This possibility emphasizes the importance of patient education regarding stroke warning signs and symptoms during the current period of isolation and social-distancing. The south Texas population, already saddled with above-average rates of cardiovascular and cerebrovascular disease, has a higher stroke mortality rate compared to Texas and U.S. averages; however, the number of patients presenting to EDs with acute ischemic stroke diagnoses is lower than average.
AB - Despite the evidence suggesting a high rate of cerebrovascular complications in patients with SARS-CoV-2, reports have indicated decreasing rates of new ischemic stroke diagnoses during the COVID-19 pandemic. The observed decrease in emergency department (ED) visits is unsurprising during this major crisis, as patients are likely to prioritize avoiding exposure to SARS-CoV-2 over addressing what they may perceive as mild symptoms of headache, lethargy, difficulty speaking, and numbness. In the central and south Texas regions where we practice, we suspect that patient admission, treatment, and discharge volumes for acute stroke treatment have decreased significantly since COVID-19-related shelter-at-home orders were issued. Symptoms of stroke are frequently noticed by a family member, friend, or community member before they are recognized by the patients themselves, and these symptoms may be going unnoticed due to limited face-to-face encounters. This possibility emphasizes the importance of patient education regarding stroke warning signs and symptoms during the current period of isolation and social-distancing. The south Texas population, already saddled with above-average rates of cardiovascular and cerebrovascular disease, has a higher stroke mortality rate compared to Texas and U.S. averages; however, the number of patients presenting to EDs with acute ischemic stroke diagnoses is lower than average.
KW - COVID-19
KW - Cerebrovascular
KW - Emergency medicine
KW - Ischemic stroke
KW - SARS-CoV-2
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=85096644396&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85096644396&partnerID=8YFLogxK
U2 - 10.2196/21608
DO - 10.2196/21608
M3 - Review article
C2 - 33006936
AN - SCOPUS:85096644396
SN - 2561-7605
VL - 3
JO - JMIR Aging
JF - JMIR Aging
IS - 2
M1 - 21608
ER -