Stroke Patients May Have Avoided Hospitals During Initial Months of Pandemic

While restrictions imposed during the early months of COVID-19 reduced the numbers of people leaving their homes except for essentials, people needing medical care too often remained at home to their detriment.

As compared to the same time last year (March-April 2019), 31 percent fewer stroke patients were admitted to the hospital as a result of the COVID-19 pandemic. Additionally, upon further analysis, patients during the pandemic appeared to have slightly more severe strokes as compared to the previous year.

In an effort to understand the impact of the COVID-19 pandemic on the number of stroke cases presenting to hospitals in U.S. cities, researchers from BUSM and other major medical centers studied the number of patients presenting with stroke symptoms to five emergency departments: Boston Medical Center and Beth Israel Deaconess Medical Center in Boston, Rhode Island Hospital in Providence, Columbia University Medical Center in New York; and Harborview Medical Center in Seattle. Each institution logged the total number of stroke alerts in the emergency department and stroke admissions by week, between Dec. 31, 2018-April 21, 2019 versus Dec. 30, 2019-April 19, 2020.

“This study confirms that the number of stroke cases we saw in the hospitals had indeed declined over the course of weeks,” said corresponding author Hugo J. Aparicio, MD, MPH, assistant professor of neurology and an investigator at the Framingham Heart Study.

“This has important implications, as the best chance of recovery for stroke patients is when they go to hospitals as soon as symptoms are recognized so that hospitals can provide comprehensive care and rehabilitation,” said lead author Malveeka Sharma, MD, MPH, assistant professor of neurology at University of Washington School of Medicine.

Management of stroke patients is time-sensitive and requires a comprehensive evaluation to have the best outcomes. According to the researchers, knowing there was a decline should prompt physicians, hospitals patient advocacy organizations and public health agencies to continuously get the message out to the community that it is important to present to the hospital with stroke-like symptoms. “Once a stroke is recognized getting help quickly is vital. Prompt treatment can mean the difference between life and death and recovery and disability,” added Dr. Aparicio, who also is a neurologist at Boston Medical Center.

These findings appear online in the journal Stroke and Vascular Neurology.

Dr. Aparicio is supported by the Boston University Chobanian Assistant Professorship and by an American Academy of Neurology Career Development Award.