A Sharp Decline in Burden of Stroke in Rural China During COVID-19 Pandemic

Abstract

This study aimed to explore trends in the burden from stroke associated with home quarantine during the COVID-19 pandemic. Patients with a first-ever stroke registered between January 1 and April 20 from 2010 to 2020 were included in this study. We compared the incidence and the rates of mortality, hospitalization, and diagnosis by neuroimaging for first-ever stroke among a low-income population in rural China during the study periods. Overall, 377 first-ever stroke patients were analyzed in this study period; men accounted for 59.2%. Compared with 2019, the incidence of first-ever stroke was 73.5% lower in 2020 (P < 0.001). The incidence of first-ever stroke was lower by 64.18% in 2020 than in the previous 5 years (P = 0.002) and by 65.42% in 2020 than in the previous 10 years (P = 0.001). Mortality from first-ever stroke in 2020 was not significantly different from that in 2019, but it was noticeably lower than that for the previous 5 and 10 years. However, rates of hospitalization and diagnosis by neuroimaging remained stable across the study period. These findings suggest that the home quarantine helped reduce outdoor activities at low temperatures, restrict gatherings, reduce alcoholism and high-fat diet, and lower pollution caused by factories. These changes were advantageous for helping high-risk groups to reduce the burden of stroke.

Increased Incidence of In-Hospital Ischemic Stroke During SARS-CoV-2 Outbreak: A Single-Center Study

“…Another previous hospital study showed that the odds of stroke was 0.25 times less likely in patients with COVID-19 in comparison with noninfected individuals during SARS-CoV-2 outbreak in New York State [ 38 ]. At a population level, a nationwide Danish study obtained an increased risk of stroke of more than ten times related to a recent diagnosis of COVID-19 [ 9 ], but a Chinese population-based prospective cohort study showed a decrease in the community incidence of ischemic stroke [ 39 ].…”

“…Another previous hospital study showed that the odds of stroke was 0.25 times less likely in patients with COVID-19 in comparison with noninfected individuals during SARS-CoV-2 outbreak in New York State [38]. At a population level, a nationwide Danish study obtained an increased risk of stroke of more than ten times related to a recent diagnosis of COVID-19 [9], but a Chinese populationbased prospective cohort study showed a decrease in the community incidence of ischemic stroke [39]. Interestingly, incidence of IHIS in our study was also increased among non-COVID-19 inpatients admitted during the SARS-CoV-2 outbreak, although adjusted estimation of the IRR for the 20NCC compared to the HNCC was not significant.…”

Impact of COVID-19 on risks and deaths of non-communicable diseases in the Western Pacific region

“…Among six studies that reported increased NCDs mortality, four were conducted in China, with the range of increase between 6.6 and 26% 12 , 16 , 19 , 21 ; one study reported in Philippines that increased by 6% compared to pre-COVID period 13 ; one study reported in Japan that increased by 27% compared to pre-COVID period. 20 Among four studies that reported decreased mortality, with the range of decrease between 1.6% and 11.9% 14 , 15 , 17 , 18 ; two studies reported in China, 17 , 18 one study reported in Japan 15 and one was in Singapore. 14 …”

“…Studies reported in-hospital mortality were found across four countries in the WPR, including China, Philippines, Japan and Singapore ( Table 1 ). Of a total of 10 included studies, eight studies reported on cardiovascular mortality, 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 one on cancer mortality 20 and one on mental health mortality. 21 Six studies reported increased mortality, 12 , 13 , 16 , 19 , 20 , 21 whereas four studies reported decreased in-hospital or after-hospital mortality.…”

“… 21 Six studies reported increased mortality, 12 , 13 , 16 , 19 , 20 , 21 whereas four studies reported decreased in-hospital or after-hospital mortality. 14 , 15 , 17 , 18 …”