During the COVID pandemic the Mexican health systems suffered major changes. Many hospitals dedicated their entire services to treatment of COVID-19 and its complications. That made referral institutions such as ours the only centers available to treat patients with acute stroke.

 From January 1st until the 30th June 2020, 202 patients with the diagnosis of stroke were admitted to our institution. Length of stay was different (14  vs 8.5 days). The type of stroke was also different, before the pandemic 35% were ischemic, 14.2% were intracerebral hemorrhage, 48.2% were subarachnoid hemorrhage. During the pandemic the proportion of Ischemic stroke (46.3%) and intracerebral hemorrhages (18.3%) were higher. More patients underwent advanced carotid imaging. (25% vs 41.5%). More patients received thrombolytic therapy (16.7% vs 28.9%) and door-to-needle time was reduced from 70.vs 41. minutes. Time from onset of symptoms increased from 644 to 839 minutes. 

The COVID 19 pandemic brought changes in the presentation an in the way we treat stroke in our center. These changes range from the difficulty for the patients to arrive to our hospital from other centers to a improvement of time to treatment. Both an increase in the number of patients due to the collapse of the local health system and the preservation of the quality of stroke care was observed.