Analysis of stroke case fatality in regional stroke center during the COVID-19 pandemic

Abstract

The aim of the study was to analyze stroke case fatality in the regional stroke center (RSC) during the COVID-19 pandemic, in order to plan the prevention measures for reduction in mortality. A retrospective comparative analysis of the medical records of stroke patients who died in October-November 2019 and 2020, i.e. before and during the 2019 Coronavirus Disease Pandemic (COVID-19) was conducted. The age of patients, the NIHSS score and the Glasgow coma score at the admission did not differ on average in 2019 and 2020. Also, there were no differences in the incidence of ischemic and hemorrhagic stroke, the rate of early and late hospitalization, the average length of stay in the RSC prior to a lethal issue, but patients in 2020 were significantly more often diagnosed with pneumonia than in 2019. A “probable” case of COVID-19 was detected in October-November 2020 in 11 of 85 (12.9%) patients with fatal stroke before the lethal issue. In 8 of these 11 patients, laboratory confirmation of COVID-19 was obtained after the death. There was a statistically significant association between the presence of a “probable” or “confirmed” case of COVID-19 and pneumonia (Chi square 12.8, p = 0.000). According to the pathomorphological study the main cause of death in fatal stroke cases in October-November 2020 was stroke and its complications in 98% and pulmonary embolism with acute respiratory failure in 2% of cases, respectively.