COVID-19 Pandemic Brings Challenges to the Management of Stroke—The Differences Between Stroke Cases Admitted to a Tertiary Hospital Before and During COVID-19 Pandemic in China

Abstract

Background An international public health emergency has resulted from the emergence of the new coronavirus-2. Both direct and indirect influences have been felt on the treatment of acute stroke. However, no conclusive link between COVID-19 and the alleged decline in admissions for stroke-related reasons has been established, and the findings of recent studies are contentious. Most of those researches are not made use of authentic data. Therefore, the goal of this study is to examine how the COVID-19 pandemic has affected hospital admissions for stroke patients, to provide a basis for managing stroke patients in hospitals during COVID-19 pandemic. Methods This retrospective study took place at the People’s Hospital of Peking University in Beijing, China. For each patient, interventions such as the application of tissue plasminogen activator (tPA) were examined. We recorded each patient’s outcomes. The stroke patients’ hospital admissions were compared to the average of the prior year. As the time span of interest, we selected the epidemic period (January 2020 to December 2020). Results When compared to the previous year in the pre-COVID period, mean monthly stroke hospitalizations decreased during the pandemic by 54.42% (P<0.001); average lengths of stay (ALOS) increased; and non-emergency admissions decreased by 78.8% (P<0.001). The monthly volume of stroke patients exceeding the intravenous thrombolysis (IVT) window decreased by 25% and 59.73%, respectively (P <0.001). There was a 5.3% increase in the percentage of IVT or within IVT time window in male stroke patients (p=0.019; p=0.049). During COVID-19, the proportion of non-local patients among male stroke patients decreased by 10% compared with the previous year (p=0.006). Conclusion The COVID-19 epidemic has had a negative impact on stroke management in China, healthcare systems must work to assess and adapt to the new reality.

Analyzing Korean Public Health Centers’ Infectious Disease Disaster Response Experiences with a Focus on Business Continuity

“…Additionally, Korea applied policies related to residential treatment centers and home treatment, causing many difficulties in resolving resource issues such as quarantine locations and transportation systems with stakeholders. 21 Given that public health center staff were in charge of these tasks, the burden of work was exacerbated. Even though inquiries related to vaccination and management of patients with adverse reactions should have been reviewed in cooperation with medical institutions to ensure the safety of community residents, public health centers’ staff handled these, leading to limitations in problem solving.…”