The impact of the COVID-19 pandemic on critically ill patients with acute stroke and diabetic ketoacidosis

Abstract

Introduction and aim. This study aimed to compare the hospitalization rate, mortality rate and morbidity status of patients hospitalized with stroke and diabetic ketoacidosis (DKA) before and during the COVID-19 pandemic. Material and methods. The data of 2522 patients who applied to the emergency department (ED) before and during the pandemic were evaluated. A Poisson regression analysis was used to examine the number of presentations between two different periods. Results. Stroke cases during the pandemic era were compared to those during the pre-pandemic period, and it was shown that the mortality rate for stroke patients during the pandemic period was much higher. Treatment-related ED presentations decreased significantly during the pandemic period, particularly among patients aged 75–84 years. Rates of ED presentation decreased by 84 percent (IRR: 0.14, 95 percent CI: 0.03-0.59) in those with DKA and by 37 percent (IRR: 0.67, 95 percent CI: 0.53- 0.75) in those with stroke during the pandemic period. Conclusion. Conclusion: Stroke and DKA admissions decreased during the pandemic, but the rate of stroke mortality increased statistically 3.375 times. Getting emergency medical care increases their chances of survival. Even in a COVID-19 outbreak, treatment is critical.

Prognostic factors for the severe course of COVID-19 in the different COVID-19 peak periods in Central Kazakhs

“…We found that in 2020-year patients' age, gender, presence of CKD, COPD, fever, increase in NLR, and decrease in oxygen saturation had significant predictive value for COVID-19 severity. The data obtained are consistent with numerous results of other works were shown the predictive value of age [16], gender [17], comorbidity [18][19][20], clinical symptoms of disease [21], and increase of NLR [22] for the prognosis of severity and death.…”

The Prediction of the Increase in intracranial Pressure in Stroke Patients Given Recombinant Tissue Plasminogen Activator by Measuring the optic Nerve Sheath Diameter on bedside Ultrasound.

“…All patients diagnosed with acute ischemic stroke treated with intravenous thrombolysis should be admitted to the ICU or specialized stroke unit for at least 24 hours of close neurologic and cardiac monitoring [14]. Intravenous (IV) thrombolysis treatment within 4.5 hours of the onset of acute ischemic stroke is associated with an increased risk of early ICH in the range of 5% to 7% [6]. Therefore, symptomatic ICH should be suspected in any patient whose neurological deterioration appears suddenly, decreased level of consciousness, new headache, nausea and vomiting, or a sudden increase in blood pressure, especially within the first 24 hours of treatment after thrombolytic therapy.…”

“…Acute stroke is a leading cause of morbidity and mortality, with more than 750,000 patients and 140,000 deaths each year, worldwide [1]. While the studies over the past 25 years have greatly expanded our ability to minimize the causing of acute stroke and maintain neurological function in many interventional neuroradiology, and neurosurgery to provide an ideal treatment [6]. The immediate goal of reperfusion therapy for acute ischemic stroke is to restore blood flow to ischemic yet infarcted areas of the brain [7].…”