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Title

Changes in Prehospital Stroke Care and Stroke Mimic Patterns during the COVID-19 Lockdown

Authors
Melaika, Kazimieras
Wiśniewski, Adam
Jaxybayeva, Altynshash
Ekkert, Aleksandra
Jatužis, Dalius
Masiliūnas, Rytis
Published in International Journal of Environmental Research and Public Health. 2021, vol. 18, no. 4, 2150
Abstract The impact of COVID-19 lockdown on prehospital stroke care is largely unknown. We aimed to compare stroke care patterns before and during a state-wide lockdown. Thus, we analysed prospective data of stroke alerts referred to our stroke centre between 1 December 2019 and 16 June 2020, and compared them between two periods-15 weeks before and 13 weeks during the state-wide lockdown declared in Lithuania on 16 March 2020. Among 719 referrals for suspected stroke, there was a decrease in stroke alerts (rate ratio 0.61, 95% CI (0.52-0.71)), stroke admissions (0.63, 95% CI (0.52-0.76)), and decrease in prehospital stroke triage quality (positive predictive value 72.1% vs. 79.9%, p = 0.042) during the lockdown. The onset-to-door time was longer (153.0 vs. 120.5 min, p = 0.049) and seizures and intracranial tumours were more common among stroke mimics (16.9% vs. 6.7%, p = 0.012 and 9.6% vs. 3.0%, p = 0.037, respectively). We conclude that there was a decline in prehospital stroke triage quality during the lockdown despite low COVID-19 incidence in the country. Moreover, we observed an increase in hospital arrival delays and severe conditions presenting as stroke mimics. Our findings suggest that improved strategies are required to maintain optimal neurological care during public health emergencies.
Keywords COVID-19Emergency medical servicesMisdiagnosisStrokeStroke mimicTriage
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PMID: 33672096
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MELAIKA, Kazimieras et al. Changes in Prehospital Stroke Care and Stroke Mimic Patterns during the COVID-19 Lockdown. In: International Journal of Environmental Research and Public Health, 2021, vol. 18, n° 4, p. 2150. doi: 10.3390/ijerph18042150 https://archive-ouverte.unige.ch/unige:151509

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Deposited on : 2021-05-07

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