Abstract Details

Title The Impact of the COVID-19 Pandemic on Acute Stroke Throughout the U.S.

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 008

Objective To determine the impacts of the pandemic on the presentation and management of patients with acute strokes across the U.S.

Background The COVID-19 pandemic has altered the management of patients across medical settings. This can be attributed to the need to reallocate resources and medical personal to control the spread of COVID-19 in the nosocomial setting. Additionally, non-COVID-19 related emergencies have declined in presentation within the U.S. healthcare system around the time of mandatory stay-at-home orders. Proposed causes include fear of contracting COVID-19 and social isolation.

Design/Methods PUBMED, PMC, and Google Scholar were used to find literature using keywords/MeSH terms including Stroke, COVID, Coronavirus, U.S., New York, Management. Articles were filtered according to year (2020), presence of full text plus abstract, and core clinical journals. Studies were limited to those in the U.S. given each country’s unique experience, response, and outcomes in regards to COVID-19.

Results There was a significant drop in patients undergoing neuroimaging secondary to stroke throughout the U.S. with the nadir corresponding to first stay-at-home orders. Studies show a 38% decrease in patients presenting with stroke-like symptoms at tertiary stroke centers across the U.S. NYU Langone Health CSC demonstrated an increased door-to-CT time and increased discharge mortality. There was a trend toward longer time since last-known-well at presentation with conflicting significance. Additionally, trends towards increased NIHSS for presenting patients indicated more severe strokes and a younger average patient population.

Conclusions Studies at this point indicate that the COVID-19 pandemic has had a potentially harmful significant impact on acute stroke presentation across the U.S. These findings may have been potentiated by sensationalized media releases and inconsistent government guidance. We expect with more data accumulation, the trends observed in these preliminary studies will become statistically significant. We suggest that future studies investigate the social and legislative influences on stroke presentation across different states.

Authors/Disclosures
Morgan E. Heber, MD (Cleveland Clinic Foundation) PRESENTER	Dr. Heber has nothing to disclose.
Mikhail A. Heber	Mr. Heber has nothing to disclose.

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Abstract Details