Evidence map›Paper›PMID 35135061›Full record

ArticleJournal of stroke2022

Trends in Stroke Presentations before and during the COVID-19 Pandemic: A Meta-Analysis.

Noman Ishaque, Asif Javed Butt, Joseph Kamtchum-Tatuene, Ali Zohair Nomani, Sarah Razzaq, Nida Fatima, Chetan Vekhande, Radhika Nair, Naveed Akhtar, Khurshid Khan and 2 more

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of stroke, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
2.2field-weighted citation impact, top 10% of its field
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Review
  7. Article
  8. Article
  9. Observational
  10. Article
  11. Review
  12. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 4 countries.

Noman IshaqueDivision of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Asif Javed ButtDivision of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Joseph Kamtchum-TatueneNeuroscience and Mental Health Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Ali Zohair NomaniDivision of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Sarah RazzaqDepartment of Medicine, Fatima Jinnah Medical University, Lahore, Pakistan.
Nida FatimaDepartment of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Chetan VekhandeDivision of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Radhika NairDivision of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Naveed AkhtarDivision of Neurology, Department of Medicine, Hamad General Hospital, Doha, Qatar.
Khurshid KhanDivision of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Maher SaqqurDepartment of Neurology, Trillium Health Care, University of Toronto, Mississauga, ON, Canada.
Ashfaq ShuaibDivision of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
University of Alberta · CAFatima Jinnah Medical University · PKHamad General Hospital · QAHarvard University · USUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeThere are reports of decline in the rates of acute emergency presentations during coronavirus disease 2019 (COVID-19) pandemic including stroke. We performed a meta-analysis of the impact of COVID-19 pandemic on rates of stroke presentations and on rates of reperfusion therapy.

methodsFollowing the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines, we systematically searched the literature for studies reporting changes in stroke presentations and treatment rates before and during the COVID-19 pandemic. Aggregated data were pooled using meta-analysis with random-effect models.

resultsWe identified 37 observational studies (n=375,657). Pooled analysis showed decline in rates of all strokes (26.0%; 95% confidence interval [CI], 22.4 to 29.7) and its subtypes; ischemic (25.3%; 95% CI, 21.0 to 30.0), hemorrhagic (27.6%; 95% CI, 20.4 to 35.5), transient ischemic attacks (41.9%; 95% CI, 34.8 to 49.3), and stroke mimics (45.6%; 95% CI, 33.5 to 58.0) during months of pandemic compared with the pre-pandemic period. The decline was most evident for mild symptoms (40% mild vs. 25%-29% moderate/severe). Although rates of intravenous thrombolytic (IVT) and endovascular thrombectomy (EVT) decreased during pandemic, the likelihood of being treated with IVT and EVT did not differ between the two periods, both in primary and in comprehensive stroke centers (odds ratio [OR], 1.08; 95% CI, 0.94 to 1.24 and OR, 0.95; 95% CI, 0.83 to 1.09, respectively).

conclusionsRates of all strokes types decreased significantly during pandemic. It is of paramount importance that general population should be educated to seek medical care immediately for stroke-like symptoms during COVID-19 pandemic. Whether delay in initiation of secondary prevention would affect eventual stroke outcomes in the long run needs further study.

Indexed as

COVID-19FibrinolysisHospitalizationMeta-analysisStrokeThrombectomy

Identifiers

PMID35135061
PMCPMC8829489
OpenAlexW4210534024

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.