COVID-19 did not result in increased hospitalization for stroke and transient ischemic attack: A nationwide study

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Background: The risk of thrombosis increases in infectious diseases, yet observational studies from single centers have shown a decrease in admission of acute ischemic stroke patients during the COVID-19 pandemic. To investigate unselected stroke admission rates we performed a nationwide study in Denmark. Methods: We extracted information from Danish national health registries. The following mutually exclusive time periods were compared to the year before the lockdown: (1) first national lockdown, (2) gradual reopening, (3) few restrictions, (4) regional lockdown, and (5) second national lockdown. Results: Generally, admission rates were unchanged during the pandemic. In the unadjusted data, we observed a small decrease in the admission rate for all strokes under the first lockdown (incidence rate ratio: 0.93, confidence interval [CI]: 0.87–0.99) and a slight increase during the periods with gradual reopening, few restrictions, and the regional lockdown driven by ischemic strokes. We found no change in the rate of severe strokes, mild strokes, or 30-day mortality. An exception was the higher mortality for all strokes during the first lockdown (risk ratio: crude 1.30 [CI: 1.03–1.59]; adjusted 1.17 [CI: 0.93–1.47]). The quality of care remained unchanged. Conclusion: Stroke admission rates remained largely unchanged during the pandemic, while an increased short-term mortality rate in patients admitted with stroke observed during the first lockdown was seen, probably reflecting that the more frail patients constituted a higher proportion of admitted patients at the beginning of the pandemic.

OriginalsprogEngelsk
TidsskriftEuropean Journal of Neurology
Vol/bind29
Udgave nummer8
Sider (fra-til)2269-2274
ISSN1351-5101
DOI
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
This study was supported by a research grant from Lundbeck Foundation. C.Z.S. is supported by a research grant from Novo Nordisk Foundation and Health Research Foundation of Central Denmark Region.

Publisher Copyright:
© 2022 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

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