The Impact of the COVID-19 Pandemic on the Stroke Unit of a Portuguese Community Hospital

It is essential to understand the consequences of the COVID-19 pandemic on stroke care, contemplating the potential health and economic consequences of missed diagnoses or treatments. This study examined the pandemic's effects on stroke epidemiology, clinical characteristics, and treatment in a hospital setting, comparing data from March 2020 to February 2021 with the homologous period the previous year. A secondary analysis focused on the state of emergency periods (March 19 to May 2 and November 6 to February 28). The sample included 730 stroke admissions, with 343 during the pandemic. There was a 24.75% reduction in the average daily occupancy rate (p<0.001) and a slight decrease in average daily admissions, especially in June from 132% to 74% (p=0.01). There was a moderate negative correlation between the number of COVID-19 cases and occupancy rates in January (r{s}=-0.422, p=0.01) and February (r{s}=-0.532, p=0.01). Admissions for ischemic stroke decreased by 7.2% (p=0.026), particularly mild events, with a 6.8% decrease in lacunar syndromes (p=0.048). Mechanical thrombectomy (MT) increased by 5.4% (p=0.046), while intravenous thrombolysis (IVT) decreased by 2.8% (p=0.048), especially in severe stroke cases (-21.4%, p=0.001). The pandemic period documented more MT procedures than IVT. Hemorrhagic stroke admissions increased by 6.7% (p=0.01). The analysis suggests a reduction in mild ischemic stroke admissions and fewer patients undergoing IVT for severe strokes during the pandemic. Broader-scale studies are necessary to confirm these findings. Considering the documented decline in diagnosis and treatment, minimizing the impact on stroke care during potential sanitary crises is paramount.