Impact of the COVID-19 Pandemic in the Acute Stroke Admissions and Outcomes in a Philippine Tertiary Hospital

Quiles, Liz Edenberg P.; Diamante, Pearl Angeli B.; Pascual, Jose Leonard R.

doi:10.1159/000525057

Cited by 8 publications

(11 citation statements)

References 21 publications

(64 reference statements)

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“…The decrease in acute ischemic stroke cases admitted during the COVID-19 period is rather expected since decline in stroke admissions was seen throughout the world during the pandemic. 7,[9][10][11][12][13] Interestingly, evident from this study is the 100% increase in hemorrhagic stroke-from 38 during the pre-COVID-19 period to 77 cases seen during the COVID-19 period. This finding may indirectly be explained by the significantly higher NIHSS scores of patients presenting to the hospital.…”

Section: Discussionmentioning

confidence: 55%

“…based measures for stroke care quality. 7 The authors aim to compare adherence to evidencebased performance measures for acute ischemic stroke care before and during the pandemic. Recognizing the impact of COVID-19 pandemic in stroke care quality would aid in making appropriate strategy adjustments in acute stroke treatment in the current and future pandemics.…”

Section: Original Articlesmentioning

confidence: 99%

“…The RES-Q is used not only in monitoring, evaluation, and improvement of stroke management in the registered institutions, but also in identifying gaps in healthcare delivery at the national, regional, and hospital level. 7 Contributing institutions have access to quarterly, bi-annual, and annual reports, and evaluations of their hospital performance based on the National Institute of Neurological Disorders and Stroke (NINDS) criteria for stroke management.…”

Section: Study Design and Subjectsmentioning

confidence: 99%

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Comparison of acute ischemic stroke care quality before and during the COVID-19 pandemic in a private tertiary hospital in metro Manila, Philippines

Delfino¹,

Carandang-Chacon²

2023

NeuroAsia

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Background: The Coronavirus Disease 2019 (COVID-19) pandemic had disrupted established medical care systems worldwide, especially for highly time-sensitive acute conditions such as stroke. Strategies to maintain the quality of stroke care during the COVID-19 outbreak are crucial to prevent indirect mortality and disability due to suboptimal care. Objective: We conducted a single center analysis to compare the time-based measures for acute ischemic stroke care quality before and during the COVID-19 pandemic. Methods: A retrospective study was done utilizing the Registry of Stroke Care Quality (RES-Q) database. All acute ischemic stroke patients who presented within 4.5 hours of symptom onset in Makati Medical Center were included. Patient characteristics, treatment received, in-hospital time-based measures of stroke care quality and clinical outcomes were compared between the two periods- pre-COVID-19 and COVID-19. Results: There were 151 patients during the pre-COVID-19 period and 108 patients during the COVID-19 period who presented to the hospital with acute ischemic strokes within 4.5 hours of symptom onset. There was significantly higher NIHSS scores on admission and MRS scores on discharge during the COVID-19 period. There was no significant difference in the door-to-scan time, door-to-needle time and door-to-groin time between the two periods. Conclusion: There is no significant change in the acute ischemic stroke care quality on the basis of in-hospital time-based measures: door-to-scan time, door-to-needle time, and door-to-groin time, between the pre-COVID-19 and COVID-19 periods. Further studies on pre-hospital challenges are recommended to identify specific targets for improvements in stroke care during pandemics.

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Section: Discussionmentioning

confidence: 55%

Section: Original Articlesmentioning

confidence: 99%

Section: Study Design and Subjectsmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of acute ischemic stroke care quality before and during the COVID-19 pandemic in a private tertiary hospital in metro Manila, Philippines

Delfino¹,

Carandang-Chacon²

2023

NeuroAsia

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“…Additionally, this finding can be attributed to a decrease in the number of minor stroke cases, which do not exceed the healthcare-seeking behavior threshold. 39,40…”

Section: Discussionmentioning

confidence: 99%

Deciphering changes in the incidence of hemorrhagic stroke and cerebral venous sinus thrombosis during the coronavirus disease 2019 pandemic: a nationwide time-series correlation study

Cho,

Kim,

Song

et al. 2024

Preprint

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IntroductionHemorrhagic stroke and cerebral venous sinus thrombosis (CVST) are associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and vaccination. We aimed to investigate changes in the incidence of hemorrhagic stroke and CVST in South Korea before and during the coronavirus disease 2019 pandemic and the factors associated with these changes.Materials and MethodsWe conducted a nationwide time-series study using population-based databases between 2007 and 2022. The real-world and forecasted incidences of acute non-traumatic subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), and CVST during the pandemic period (2020–2022) were estimated and compared with the pre-pandemic period (2007–2019). The prevalence of conventional risk factors was measured using time-series data. Finally, a time-series correlation analysis was performed to examine the temporal association between conventional risk factors, SARS-CoV-2 infection, and SARS-CoV-2 vaccination.ResultsThe incidence of hemorrhagic stroke (SAH and ICH) was lower during the pandemic than during the pre-pandemic period. This observed decrease was associated with a reduction in the prevalence of conventional risk factors but not with SARS-CoV-2 infection or vaccination. The incidence of CVST was higher during the pandemic than during the pre-pandemic period, which may be temporally related to SARS-CoV-2 vaccination (Pearson correlation coefficient [r] = 0.349,P= 0.031).ConclusionWe report reassuring evidence of hemorrhagic stroke associated with SARS-CoV-2 infection and vaccination. However, awareness of CVST may be required for future vaccine rollouts and SARS-CoV-2 outbreaks.

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“…After the outbreak of the COVID-19 pandemic, diverse prehospital time intervals for suspected AIS patients have been reported [15,20,21,22]. In these publications, the study periods before and after the outbreak of the pandemic have ranged from a month to a year.…”

Section: Introductionmentioning

confidence: 99%

Prehospital time intervals in stroke care before and after the outbreak of COVID-19

Hänninen,

Hällberg,

Hakala

et al. 2023

Preprint

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Background A prehospital emergency medical system is essential in order to provide rapid treatment for stroke patients. After the outbreak of COVID-19, precautions and safety measures were introduced to limit the number of infections. This study analyzed the long-term effects of COVID-19 on the stroke care process in prehospital care. Methods In this retrospective study, we examined the effects of the COVID-19 pandemic on the emergency medical care of patients transported to the Kanta-Häme Central Hospital because of suspected stroke. We collected prehospital data on the emergency medical services’ time intervals of suspected stroke patients, including on-scene time and total time. Emergency medical services’ time intervals of transported suspected stroke patients 24 months before and 24 months after the outbreak of COVID-19 were compared. Results During the study period, emergency medical services transported altogether 1,226 patients with suspected stroke to the Kanta-Häme Central Hospital emergency department, 552 before and 674 after the COVID-19 outbreak. The median on-scene time of these patients was 15.38 minutes before and 15.18 minutes after the outbreak (p = 0.93). The median total emergency medical services time had remained stable between the groups, 49.59 minutes vs. 49.86 minutes (p = 0.80) respectively. Conclusions The number of suspected stroke patients increased by 22.9% after the outbreak of the COVID-19 pandemic. However, the pandemic outbreak did not lengthen the pre-hospitalisation intervals for suspected stroke patients. These results allow us to assume that once the prehospital process of suspected stroke patients has been thoroughly reorganized, not even a serious epidemic will impair the function of emergency medical services.

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Impact of the COVID-19 Pandemic in the Acute Stroke Admissions and Outcomes in a Philippine Tertiary Hospital

Cited by 8 publications

References 21 publications

Comparison of acute ischemic stroke care quality before and during the COVID-19 pandemic in a private tertiary hospital in metro Manila, Philippines

Comparison of acute ischemic stroke care quality before and during the COVID-19 pandemic in a private tertiary hospital in metro Manila, Philippines

Deciphering changes in the incidence of hemorrhagic stroke and cerebral venous sinus thrombosis during the coronavirus disease 2019 pandemic: a nationwide time-series correlation study

Prehospital time intervals in stroke care before and after the outbreak of COVID-19

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