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Changes in stroke and TIA admissions during the COVID-19 pandemic: A meta-analysis
Örebro University, School of Medical Sciences. Department of Neurology and rehabilitation, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.
Örebro University, School of Medical Sciences. Department of Neurology and rehabilitation, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.ORCID iD: 0000-0003-1712-7510
Department of Neurology and rehabilitation, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.
Örebro University, School of Medical Sciences. Örebro University Hospital. Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden; Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0002-3552-9153
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2024 (English)In: European Stroke Journal, ISSN 2396-9873, E-ISSN 2396-9881, Vol. 9, no 1, p. 78-87Article, review/survey (Refereed) Published
Abstract [en]

PURPOSE: To perform a meta-analysis on how the admissions of stroke and transient ischemic attack (TIA) changed during the Corona Virus infection-19 (COVID-19) pandemic and evaluate if the effect was depending on stroke severity.

METHODS: Observational cohort studies comparing the number of stroke and/or TIA admissions during a period of the pandemic compared to a period before the pandemic were identified in PubMed and Embase. After excluding studies with overlapping populations and studies without satisfactory case ascertainment, data was extracted and meta-analyzed.

FINDINGS: A total of 59 studies were included. During the pandemic, there was a decrease in admissions of ischemic stroke (admission rate ratio (ARR) = 0.77, 95% confidence interval (CI): 0.72, 0.82), intracerebral hemorrhage (ARR = 0.79, 95% CI: 0.70, 0.90) and TIA (ARR = 0.66, 95% CI: 0.58, 0.75). Albeit admission rates of both mild (ARR = 0.61, 95% CI: 0.49, 0.77) and severe (ARR = 0.82, 95% CI = 0.71, 0.95) strokes decreased, milder strokes decreased more (proportion ratio (PR) = 0.76, 95% CI: 0.65, 0.89).

DISCUSSION: Potential causes for the admission reduction could be strict prioritizations within the health care, patients' fear of acquiring COVID-19, or decreased access to health care due to lockdowns.

CONCLUSION: During the COVID-19 pandemic, there was a reduction in admissions of stroke and TIA, possibly caused by reluctance to seek medical care.

Place, publisher, year, edition, pages
Sage Publications, 2024. Vol. 9, no 1, p. 78-87
Keywords [en]
Acute ischemic stroke, Corona virus, NIHSS, SARS-CoV-2, TIA, cerebral infarction, intracerebral hemorrhage
National Category
Public Health, Global Health, Social Medicine and Epidemiology Neurology
Identifiers
URN: urn:nbn:se:oru:diva-108656DOI: 10.1177/23969873231204127ISI: 001073208700001PubMedID: 37776062Scopus ID: 2-s2.0-85173493290OAI: oai:DiVA.org:oru-108656DiVA, id: diva2:1801747
Available from: 2023-10-02 Created: 2023-10-02 Last updated: 2024-03-22Bibliographically approved

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Gunnarsson, KarinTofiq, avinCao, Yangvon Euler, MiaStröm, Jakob O.

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