Collateral damages of COVID-19 on the hungarian ischemic stroke care

Böjti, P. P.; Szilágyi, G.; Dobi, B.; Stang, R.; Szikora, I.; Kis, B.; Kornfeld, Á Óváry C.; Erőss, L.; Banczerowski, P.; Kuczyński, W.; Bereczki, D.

IntroductionAlthough most of the stroke centers reported a remarkable decline in stroke care during the coronavirus disease 2019 (COVID-19) pandemic, data from Central Europe are limited.ObjectivesWe aimed to assess the impact of the ongoing pandemic on the Hungarian ischemic stroke (IS) care system.MethodsAt a national level, we retrospectively accessed the number of IS admissions and reperfusion therapies, i.e., intravenous thrombolysis (IVT) and endovascular therapy (EVT), from 2 January 2017 to 31 December 2020 in Hungary. We used different statistics (means, medians, trends, relative rates, linear relationships) to analyze the impact of the COVID-19 outbreak on the number of IS admissions and reperfusion therapies.ResultsAlthough the non-standardized number of IS admissions, IVTs and EVTs decreased only in some measure during the COVID-19 epidemic, the trend analysis demonstrated a significant disruption in the trends. The reduction’s dynamic and extent have differed for each variable, and the number of IS admissions decreased to a disproportionally larger extent than the number of IVTs and EVTs. In contrast to IVT, the number of IS admissions and EVTs showed a significant negative linear correlation with the number of new or cumulative COVID-19 cases in Hungary.ConclusionsCollateral damages of the COVID-19 outbreak on the Hungarian IS care system were demonstrated. The disproportionally greater decline of IS admission numbers could partially be explained by the effect of health emergency operative measures. Further studies are needed to evaluate the causes of our observations.ReferencesBersano A, Kraemer M, Touzé E, Weber R, Alamowitch S, Sibon I, et al. Stroke care during the COVID-19 pandemic: experience from three large European countries. Eur J Neurol 2020;27(9):1794–800. https://doi.org/10.1111/ene.14375Böjti PP, Stang R, Gunda B, Sipos I, Bereczki D. A járulékos egészségügyi veszteségek retrospektív, egycentrumos felmérése. [Effects of COVID-19 pandemic on acute ischemic stroke care. A single-centre retrospective analysis of medical collateral damage]. Orv Hetil 2020;161(34):1395–9. https://doi.org/10.1556/650.2020.31936. Hungarian.Slowik A, Nowak R, Popiela T. Significant fall in stroke admissions in the Malopolska Voivodeship of Poland during the COVID-19 pandemic. Neurol Neurochir Pol 2020;54(5):471–2. https://doi.org/10.5603/PJNNS.a2020.0056DisclosureNothing to disclose