ArticleStroke2020
Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic.
Open access · greenAbstract read
In one paragraph
Article in Stroke, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 4 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 4 pooled it
6.9field-weighted citation impact, top 2% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
60 citing papers in PubMed, 4 syntheses or guidelines pooled it, 97 citations in OpenAlex.
- Pooled it
- Changes in Stroke Hospital Care During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis.Stroke · 2021Pooled it
- Stroke network performance during the first COVID-19 pandemic stage: A meta-analysis based on stroke network models.International journal of stroke : official journal of the International Stroke Society · 2021Pooled it
- COVID-19 and Cerebrovascular Diseases: A Systematic Review and Perspectives for Stroke Management.Frontiers in neurology · 2020Pooled it
- Trial
- Trends in the Association of Neighborhood Socioeconomic Status With Stroke Incidence and Mortality From 2000 to 2022: A Population-Based Study.Journal of the American Heart Association · 2026Article
- Article
- Changes in Healthcare Utilization Patterns and Outcomes for an Acute Cerebrovascular Events Medicare Cohort: 2018-2022.Neuroepidemiology · 2026Article
- Artificial Intelligence in Pharmaceutical Drug Development: Transforming Formulation and Innovation.Current drug discovery technologies · 2026Review
- Association Between Sociodemographic Disparities and Door to Computerized Tomography Time in Patients with Acute Ischemic Stroke Across COVID-19 Periods in the Emergency Department: A Multi-Center Cohort Study.Medical sciences (Basel, Switzerland) · 2025Article
- Article
- StrokeClassifier: ischemic stroke etiology classification by ensemble consensus modeling using electronic health records.NPJ digital medicine · 2024Article
- Trends in stroke severity at hospital admission and rehabilitation discharge before and during the COVID-19 pandemic in Hesse, Germany: a register-based study.Neurological research and practice · 2024Article
- Association of Neighborhood-Level Socioeconomic Factors With Delay to Hospital Arrival in Patients With Acute Stroke.Neurology · 2024Observational
- Stroke but no hospital admission: Lost opportunity for whom?PloS one · 2024Article
- Oxidative Stress and Antioxidant Defense Mechanisms in Acute Ischemic Stroke Patients with Concurrent COVID-19 Infection.International journal of molecular sciences · 2023Article
- Article
- Hospital Discharge and Readmissions Before and During the COVID-19 Pandemic for California Acute Stroke Inpatients.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2023Observational
- Long-term evaluation of the COVID-19 pandemic impact on acute stroke management: an analysis of the 21-month data from a medical facility in Tokyo.Acta neurologica Belgica · 2023Article
- Quality in stroke care during the early phases of the COVID-19 pandemic: A nationwide study.European stroke journal · 2023Article
Corrections and comments
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Authors and funding
27 authors at 2 institutions in 2 countries.
Adam S JasneDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Pola ChojeckaDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Ilavarasy MaranDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Razaz MageidDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Mohamed EldokmakDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Qiang ZhangDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Karin NystromDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Kelsey VlieksDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Michael AskenaseDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Nils PetersenDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Guido J FalconeDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Charles R WiraDepartment of Emergency Medicine (C.R.W.), Yale University School of Medicine, New Haven, CT.
Paul LlevaDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Neer ZeeviDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Reshma NarulaDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Hardik AminDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Dhasakumar NavaratnamDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Caitlin LoomisDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
David Y HwangDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Joseph SchindlerDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Ryan HebertDepartments of Neurosurgery and of Radiology and Biomedical Imaging (R.H., C.M.), Yale University School of Medicine, New Haven, CT.
Charles MatoukDepartments of Neurosurgery and of Radiology and Biomedical Imaging (R.H., C.M.), Yale University School of Medicine, New Haven, CT.
Harlan M KrumholzDepartment of Cardiology (H.M.K.), Yale University School of Medicine, New Haven, CT.
Serena SpudichDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Kevin N ShethDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Lauren H SansingDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Richa SharmaDepartment of Neurology (A.S.J., P.C., I.M., R.M., M.E., Q.Z., K.N., K.V., M.A., N.P., G.J.F., P.L., N.Z., R.N., H.A., D.N., C.L., D.Y.H., J.S., S.S., K.N.S., L.H.S., R.S.), Yale University School of Medicine, New Haven, CT.
Norwegian Womens Public Health Association · NOYale University · US
Funding
Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9MAnticoagulation in ICH Survivors for Prevention and Recovery (ASPIRE)U01NS106513 · NINDS · YALE UNIVERSITY · PI Hooman Kamel, Kevin Navin Sheth · 2019 to 2026
$20.6MCerebrovascular Fellowship Training ProgramT32NS047996 · NINDS · UNIVERSITY OF CINCINNATI · PI Joseph Paul Broderick, Stacie Demel · 2006 to 2026
$3.7MThe Recovery in Stroke Using PAP (RISE UP) StudyR01NR018335 · NINR · YALE UNIVERSITY · PI REDEKER, NANCY S, SHETH, KEVIN NAVIN · 2019 to 2023
$3.4MSouthern New England Partnership In Stroke Research, Innovation and Treatment (SPIRIT)U24NS107215 · NINDS · YALE UNIVERSITY · PI MARK Jay ALBERTS, Karen L Furie · 2018 to 2026
$3.0MImproved glyburide therapy via acid- triggered release functional nanoparticles and therapeutic imagingR01NS110721 · NINDS · YALE UNIVERSITY · PI SHETH, KEVIN NAVIN, ZHOU, JIANGBING · 2019 to 2023
$1.9MYale Clinical Site: Investigations For Improved Neurological Treatments at Yale (INFINITY)U24NS107136 · NINDS · YALE UNIVERSITY · PI SHETH, KEVIN NAVIN, SPUDICH, SERENA S · 2018 to 2022
$1.7MPrecision blood pressure management after endovascular stroke therapy based on real-time autoregulation measurementsK23NS110980 · NINDS · YALE UNIVERSITY · PI PETERSEN, NILS H. · 2020 to 2024
$951kIntensive Blood Pressure Reduction in Deep Intracerebral HemorrhageR03NS112859 · NINDS · YALE UNIVERSITY · PI FALCONE, GUIDO JOSE, SHETH, KEVIN NAVIN · 2019 to 2020
$84kNCATS NIH HHS UL1 TR001863NINDS NIH HHS K23 NS110980NINDS NIH HHS R01 NS110721NINDS NIH HHS R03 NS112859NINDS NIH HHS T32 NS047996NINDS NIH HHS U01 NS106513NINDS NIH HHS U24 NS107136NINDS NIH HHS U24 NS107215NINR NIH HHS R01 NR018335
Abstract
backgroundAnecdotal reports suggest fewer patients with stroke symptoms are presenting to hospitals during the coronavirus disease 2019 (COVID-19) pandemic. We quantify trends in stroke code calls and treatments at 3 Connecticut hospitals during the local emergence of COVID-19 and examine patient characteristics and stroke process measures at a Comprehensive Stroke Center (CSC) before and during the pandemic.
methodsStroke code activity was analyzed from January 1 to April 28, 2020, and corresponding dates in 2019. Piecewise linear regression and spline models identified when stroke codes in 2020 began to decline and when they fell below 2019 levels. Patient-level data were analyzed in February versus March and April 2020 at the CSC to identify differences in patient characteristics during the pandemic.
resultsA total of 822 stroke codes were activated at 3 hospitals from January 1 to April 28, 2020. The number of stroke codes/wk decreased by 12.8/wk from February 18 to March 16 (
conclusionsHospital presentation for stroke-like symptoms decreased during the COVID-19 pandemic, without differences in stroke severity or early outcomes. Individuals living outside of the CSC city were less likely to present for stroke codes at the CSC during the pandemic. Public health initiatives to increase awareness of presenting for non-COVID-19 medical emergencies such as stroke during the pandemic are critical.
Indexed as
AgedAged, 80 and overBetacoronavirusBrain IschemiaCohort StudiesComorbidityConnecticutCoronary Artery DiseaseCoronavirus InfectionsCOVID-19DyslipidemiasEmergency Medical ServicesEthnicityFemaleHumansHypertensioncoronavirus diseasepandemicsstroke
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