Stroke activations per week declined by 39% just after statewide school, restaurant and bar closing measures were announced in Ohio, Kentucky and Indiana in mid-March. The researchers say that by comparing these efforts with a similar time period in 2019, the findings suggest that the precipitous drop in stroke calls and treatments is due to announcement of COVID-19 restrictions.
“Our findings are very concerning for the health of our region,” says Pooja Khatri, MD, professor in the Department of Neurology at the UC College of Medicine, co-director of the UC Stroke Team and co-senior author of the study. “It’s unlikely that 40% of strokes disappeared coincidentally with the governors’ announcements and it’s also very unlikely that COVID-19 is reducing the incidence of stroke. The pandemic may actually increase the risk of stroke.”
Treatment for acute strokes is highly time-sensitive and has a major impact on clinical outcomes. Effective treatment requires the patient presenting to an emergency department as soon as possible, ideally within an hour from when symptoms start, which gives the best chance of preventing lifelong disability.
“The most concerning interpretation of these findings is that stroke patients are not seeking needed care right away,” Opeolu Adeoye, MD, associate professor in the Department of Emergency Medicine at the UC College of Medicine, co-director of the UC Stroke Team and co-senior author of the study. “Given no evidence that the severity of stroke increased while treatment rates declined, even patients with severe strokes may be seeking reduced or delayed treatment. With the extensions of statewide stay-at-home orders due to COVID-19, it’s possible that this decrease in stroke evaluations and other treatments may continue or get worse.”
Khatri added, “Patients who are afraid to seek emergency care are likely missing treatments for stroke that have to be given quickly, within hours, to be most effective. Thankfully, to date, hospitals in the region continue to have the capacity to care for stroke patients and have safe practices in place to make sure COVID-19 transmission is unlikely.””