Reduction in Acute Stroke Admissions during the COVID-19 Pandemic: Data from a National Stroke Registry

Libruder, Carmit; Ram, Amit; Hershkovitz, Yael; Tanné, David; Bornstein, Natan M.; Leker, Ronen R.; Horev, Anat; Hallevi, Hen; Peretz, Shlomi; Orion, David; Zucker, Inbar

doi:10.1159/000516753

Cited by 17 publications

(24 citation statements)

References 24 publications

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“…In aggregate, there were reductions in cardiac diagnoses and at a granular level there were reductions in atrial fibrillation as well as myocardial infarction, with potential downstream consequences, for example if fewer people with atrial fibrillation received stroke preventing anticoagulants. We observed no change in cerebral infarction strokes during the first wave, although a study in Israel found a reduction of 29% for stroke and a UK-wide registry study found only a 12% reduction in stroke admissions at the peak of the first wave [ 52 , 53 ]. Our data suggest a possible trend towards increased strokes in the last months of our analysis which, if confirmed over time, might reflect reduced opportunities for stroke prevention during the pandemic.…”

Section: Discussioncontrasting

confidence: 59%

Impact of the COVID-19 pandemic on emergency department attendances and acute medical admissions

et al. 2021

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Background To better understand the impact of the COVID-19 pandemic on hospital healthcare, we studied activity in the emergency department (ED) and acute medicine department of a major UK hospital. Methods Electronic patient records for all adult patients attending ED (n = 243,667) or acute medicine (n = 82,899) during the pandemic (2020–2021) and prior year (2019) were analysed and compared. We studied parameters including severity, primary diagnoses, co-morbidity, admission rate, length of stay, bed occupancy, and mortality, with a focus on non-COVID-19 diseases. Results During the first wave of the pandemic, daily ED attendance fell by 37%, medical admissions by 30% and medical bed occupancy by 27%, but all returned to normal within a year. ED attendances and medical admissions fell across all age ranges; the greatest reductions were seen for younger adults in ED attendances, but in older adults for medical admissions. Compared to non-COVID-19 pandemic admissions, COVID-19 admissions were enriched for minority ethnic groups, for dementia, obesity and diabetes, but had lower rates of malignancy. Compared to the pre-pandemic period, non-COVID-19 pandemic admissions had more hypertension, cerebrovascular disease, liver disease, and obesity. There were fewer low severity ED attendances during the pandemic and fewer medical admissions across all severity categories. There were fewer ED attendances with common non-respiratory illnesses including cardiac diagnoses, but no change in cardiac arrests. COVID-19 was the commonest diagnosis amongst medical admissions during the first wave and there were fewer diagnoses of pneumonia, myocardial infarction, heart failure, cellulitis, chronic obstructive pulmonary disease, urinary tract infection and other sepsis, but not stroke. Levels had rebounded by a year later with a trend to higher levels of stroke than before the pandemic. During the pandemic first wave, 7-day mortality was increased for ED attendances, but not for non-COVID-19 medical admissions. Conclusions Reduced ED attendances in the first wave of the pandemic suggest opportunities for reducing low severity presentations to ED in the future, but also raise the possibility of harm from delayed or missed care. Reassuringly, recent rises in attendance and admissions indicate that any deterrent effect of the pandemic on attendance is diminishing.

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Section: Discussioncontrasting

confidence: 59%

Impact of the COVID-19 pandemic on emergency department attendances and acute medical admissions

et al. 2021

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“…In our study, we used a Poisson regression model with robust variance as used in other studies that evaluated the impact of the COVID-19 pandemic on hospital admissions [28][29][30][31]. As mentioned, this model allowed including gender, age group, region of Brazil, the dummy variable representing the impact of the COVID-19 pandemic ("0", pre-pandemic period; "1", pandemic period) and the month of admission to control for possible seasonal variations as dependent variables.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the impact of coronavirus disease 19 on hospitalization rates for chronic non-communicable diseases in Brazil

et al. 2022

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Background The coronavirus disease (COVID-19) pandemic has impacted health services and healthcare systems worldwide. Studies have shown that hospital admissions for causes related to chronic non-communicable diseases (NCDs) have decreased significantly during peak pandemic periods. An analysis of the impact of the COVID-19 pandemic on hospital admissions for NCDs is essential to implement disability and mortality mitigation strategies for these groups. Therefore, this study aimed to analyze the impact of the COVID-19 pandemic on hospital admissions for NCDs in Brazil according to the type of NCD, sex, age group, and region of Brazil. Methods This is an ecological study conducted in Brazil. Data on hospital admissions from January 1, 2017 to May 31, 2021 were extracted from the Unified Health System’s Hospital Admissions Information System. The hospital admission rates per 100,000 thousand inhabitants were calculated monthly according to the type of NCD, sex, age group, and region of Brazil. Poisson regression models were used to analyze the impact of the COVID-19 pandemic on the number of hospital admissions. In this study, the pre-pandemic period was set from January 1, 2017 to February 29, 2020 and the during-pandemic from March 1, 2020 to May 31, 2021. Results There was a 27.0% (95.0%CI: -29.0; -25.0%) decrease in hospital admissions for NCDs after the onset of the pandemic compared to that during the pre-pandemic period. Decreases were found for all types of NCDs—cancer (-23.0%; 95.0%CI: -26.0; -21.0%), diabetes mellitus (-24.0%; 95.0%CI: -25.0%; -22.0%), cardiovascular diseases (-30.0%; 95.0%CI: -31.0%; -28.0%), and chronic respiratory diseases (-29.0%; 95.0%CI: -30.0%; -27.0%). In addition, there was a decrease in the number of admissions, regardless of the age group, sex, and region of Brazil. The Northern and Southern regions demonstrated the largest decrease in the percentage of hospital admissions during the pandemic period. Conclusions There was a decrease in the hospitalization rate for NCDs in Brazil during the COVID-19 pandemic in a scenario of social distancing measures and overload of health services.

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“…Inconvenience for patients seeking treatment might be one of the reasons for the decrease of endocrine, nutritional and metabolic diseases 13. A large proportion of hospitalised patients in this group in the paediatric department of FJMUUH were those with low-acuity diseases, such as dwarfism, sexual precocity and malnutrition, who might not draw enough attention from guardians during the pandemic period.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on paediatric admissions to a Chinese hospital: a single-centre retrospective chart review

Zheng

Chen

2022

BMJ Open

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ObjectiveTo explore the impact of the COVID-19 on the distribution, type and patterns of diseases in hospitalised children under local antiepidemic measures.DesignRetrospective chart review.SettingElectronic medical records of patients hospitalised in the paediatric department of a tertiary hospital in South China from 21 January 2019 to 20 January 2021.ParticipantsRecords of 2139 patients.Outcome measuresData were analysed before and during the COVID-19 pandemic. Disease characteristics were analysed based on the 10th revision of the International Statistical Classification of Diseases and Related Health Problems. Features of the length of hospital stay were investigated. Categorical variables involving more than three groups were analysed using an overall χ2 test, followed by pairwise comparisons.ResultsDuring the COVID-19 outbreak period, paediatric hospitalisation was reduced by 29.6%, from 1255 to 884. The proportions of infection-related diseases (36.3% (455 cases) vs 20.8% (184 cases)), respiratory system-related diseases (22.5% (283 cases) vs 9.4% (83 cases)); and endocrine, nutritional and metabolic diseases (17.1% (214 cases) vs 9.2% (81 cases)) decreased significantly, whereas that of musculoskeletal and connective tissue diseases increased from 11.0% (138 cases) to 20.1% (178 cases), thereby becoming the most common reason for hospitalisation. The proportions of diseases of the nervous system (12.4% (156 cases) to 18.8% (166 cases)) and mental and behavioural disorders (0.2% (3 cases) to 2.1% (19 cases)) increased significantly. The average length of hospital stay increased after the outbreak (7.57±6.53 vs 8.36±6.87).ConclusionThe number of hospitalisation cases decreased during the COVID-19 period. The prominent decreases in hospitalisation associated with infections and respiratory system diseases were likely attributed to the improved epidemic prevention work, enhancement of people’s health awareness and fear of possible exposure to COVID-19. Describing the impact of COVID-19 on disease patterns may provide a reference for resource planning during the pandemic.

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Reduction in Acute Stroke Admissions during the COVID-19 Pandemic: Data from a National Stroke Registry

Cited by 17 publications

References 24 publications

Impact of the COVID-19 pandemic on emergency department attendances and acute medical admissions

Impact of the COVID-19 pandemic on emergency department attendances and acute medical admissions

Analysis of the impact of coronavirus disease 19 on hospitalization rates for chronic non-communicable diseases in Brazil

Impact of COVID-19 on paediatric admissions to a Chinese hospital: a single-centre retrospective chart review

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