Burton J. Tabaac, MD
@burtontabaac
Diegoli
H, Magalhães PSC, Martins SCO, Moro CHC, França PHC, Safanelli J, Nagel, V, Venancio
VG, Liberato RB, Longo AL. Decrease in Hospital Admissions for Transient
Ischemic Attack, Mild, and Moderate Stroke During the COVID-19 Era. Stroke.
2020.
On March 11, 2020, the World Health Organization declared Coronavirus
Disease 2019 (COVID-19) a pandemic. As of this writing, the global number of
cases exceeds 8.1 million. However, despite the rapidly increasing prevalence
of COVID-19, many questions remain regarding this unusual and highly lethal
disease. The pathogenesis of COVID-19–associated neurologic injury remains to
be established. SARS-CoV-2 has been shown to induce a hypercoagulable state,
thus increasing the risk of arterial thrombosis with acute ischemic stroke.(1)
From late 2019 to early 2020, COVID-19 started to disrupt the
healthcare systems of many nations. From the beginning of the pandemic, it has
been a major concern for doctors and public authorities that resources needed
to treat other conditions such as stroke are diverted for COVID-19.(2) The
authors are keen to note that “patients may be unwilling to go to a hospital
for stroke treatment due to fear of becoming contaminated with the disease.”
Using a population-based stroke registry, the authors of this original
contribution investigated the impact of the onset of the COVID-19 pandemic on
stroke admissions in Joinville, Brazil. The authors’ hypotheses were as follows:
First, hospital admissions for stroke were reduced after the onset of the
COVID-19 pandemic. Next, the reduction occurred only in transient ischemic
attacks (TIA) and mild cases. Also, there was a change in the time between
stroke onset and hospital admissions. Finally, the number of patients receiving
reperfusion therapies (IVT and MT) has decreased.