Anne-Sophie Mariet1,2,3, Maurice Giroud4, Eric Benzenine1, Jonathan Cottenet1, Adrien Roussot1, Ludwig Serge Aho-Glélé5, Pascale Tubert-Bitter6, Yannick Béjot4, Catherine Quantin1,2,3,6. 1. Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France (A.-S.M., E.B., J.C., A.R., C.Q.). 2. Inserm, CIC 1432, Dijon, France (A.-S.M., C.Q.). 3. Dijon University Hospital, Clinical Investigation Center, clinical epidemiology/clinical trials unit, France (A.-S.M., C.Q.). 4. Dijon Stroke Registry - EA7460 (Pathophysiology and Epidemiology of Cerebro-Cardio-Vascular Diseases), University of Burgundy - UBFC (M.G., Y.B.), University Hospital of Dijon, Bourgogne, France. 5. Department of Epidemiology and Hospital Hygiene (L.S.A.-G.), University Hospital of Dijon, Bourgogne, France. 6. Université Paris-Saclay, UVSQ, Université Paris-Sud, Inserm, High-Dimensional Biostatistics for Drug Safety and Genomics, CESP, Villejuif, France (P.T.-B., C.Q.).
Abstract
BACKGROUND AND PURPOSE: In France, the entire population was put under a total lockdown from March 17 to May 11, 2020 during the peak of the coronavirus disease 2019 (COVID-19) pandemic. Whether the lockdown had consequences on the management of medical emergencies such as stroke and transient ischemic attack (TIA) has yet to be fully evaluated. This article describes hospitalization rates for acute stroke in 2 French regions that experienced contrasting rates of COVID-19 infection, before, during, and after the nationwide lockdown (January to June 2020). METHODS: All patients admitted for acute stroke/TIA into all public and private hospitals of the 2 study regions were included. Data were retrieved from the National Hospitalization Database (PMSI). In the most affected region (Grand-Est), the hospitalization rates observed in April 2020 were compared with the rates in the same period in the least affected region (Occitanie) and in the 3 prior years (2017-2019). RESULTS: There was a significant decline in hospitalization rates for stroke/TIA within the region most affected by COVID-19 during the month of April 2020 compared with previous years, while no significant change was seen in the least affected region. After lockdown, we observed a fast rebound in the rate of hospitalization for stroke/TIA in the most affected region, contrasting with a slower rebound in the least affected region. In both regions, patients with COVID-19 stroke more frequently had ischemic stroke, a nonsignificant greater prevalence of diabetes, they were less frequently admitted to stroke units, and mortality was higher than in patients without COVID-19. CONCLUSIONS: Our results demonstrates a significant drop in stroke/TIA hospitalizations and a fast recovery after the end of the French lockdown in the most affected region, while the least affected region saw a nonsignificant drop in stroke/TIA hospitalizations and a slow recovery. These results and recommendations could be used by the health authorities to prepare for future challenges.
BACKGROUND AND PURPOSE: In France, the entire population was put under a total lockdown from March 17 to May 11, 2020 during the peak of the coronavirus disease 2019 (COVID-19) pandemic. Whether the lockdown had consequences on the management of medical emergencies such as stroke and transient ischemic attack (TIA) has yet to be fully evaluated. This article describes hospitalization rates for acute stroke in 2 French regions that experienced contrasting rates of COVID-19infection, before, during, and after the nationwide lockdown (January to June 2020). METHODS: All patients admitted for acute stroke/TIA into all public and private hospitals of the 2 study regions were included. Data were retrieved from the National Hospitalization Database (PMSI). In the most affected region (Grand-Est), the hospitalization rates observed in April 2020 were compared with the rates in the same period in the least affected region (Occitanie) and in the 3 prior years (2017-2019). RESULTS: There was a significant decline in hospitalization rates for stroke/TIA within the region most affected by COVID-19 during the month of April 2020 compared with previous years, while no significant change was seen in the least affected region. After lockdown, we observed a fast rebound in the rate of hospitalization for stroke/TIA in the most affected region, contrasting with a slower rebound in the least affected region. In both regions, patients with COVID-19stroke more frequently had ischemic stroke, a nonsignificant greater prevalence of diabetes, they were less frequently admitted to stroke units, and mortality was higher than in patients without COVID-19. CONCLUSIONS: Our results demonstrates a significant drop in stroke/TIA hospitalizations and a fast recovery after the end of the French lockdown in the most affected region, while the least affected region saw a nonsignificant drop in stroke/TIA hospitalizations and a slow recovery. These results and recommendations could be used by the health authorities to prepare for future challenges.
Authors: Nina Hangartner; Stefania Di Gangi; Christoph Elbl; Oliver Senn; Fadri Bisatz; Thomas Fehr Journal: PLoS One Date: 2022-06-10 Impact factor: 3.752
Authors: Pedro Cougo; Bruno Besen; Daniel Bezerra; Rodrigo de Carvalho Moreira; Carlos Eduardo Brandão; Emmanuel Salgueiro; Alex Balduino; Octávio Pontes-Neto; Victor Cravo Journal: J Stroke Cerebrovasc Dis Date: 2022-02-21 Impact factor: 2.677