Abstract TP25: Acute Stroke Patients With Low NIHSS Did Not Delay Hospital Presentation During COVID

Abstract

Hypothesis: Hospital presentation for acute stroke may have been delayed during COVID-19. We hypothesize that stroke patients with mild symptoms (NIHSS <= 5) were more likely to present in a delayed fashion during the early days of the pandemic. Methods: Get with The Guidelines Stroke registry was used to identify stroke patients that presented between January 1 and August 31, 2020 to the University Hospital in San Antonio, Texas. The cohort was stratified by date of presentation (before COVID: Jan 1 - Mar 15; during COVID: Mar 16 - Aug 31) and presenting NIHSS (<=5 versus >5). We then analyzed by the thrombolytic exclusion criteria delay to arrival and the time interval of stroke symptoms discovery to hospital presentation. Subgroup analysis included age, sex, and ethnicity; race was excluded due to 90% Caucasian cohort. Results: A total of 294 subjects were included of which 115 were before and 179 were during COVID. There were no significant differences in the demographics for these two time periods, although a trend for greater male presentation was seen during COVID (Table 1). After both groups were dichotomized by NIHSS <=5, stroke symptoms discovery to hospital arrival and delay to arrival (Table 2) were not significantly different across subgroups. Conclusions: Regardless of NIHSS, a significant time delay in acute stroke presentation to our hospital was not seen when comparing before and during COVID. Although our study included a large Hispanic population, the cohort was primarily Caucasian; and therefore, the results have limited application. Whether men were more likely than women to present with stroke during COVID is unclear but warrants further study with a larger sample size.