ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2022
Changes in ischemic stroke presentations, management and outcomes during the first year of the COVID-19 pandemic in Alberta: a population study.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed.
- Changes in Healthcare Utilization Patterns and Outcomes for an Acute Cerebrovascular Events Medicare Cohort: 2018-2022.Neuroepidemiology · 2026Article
- The impact of the COVID-19 pandemic on longitudinal trends of surgical mortality and inpatient quality of care in Ontario, Canada.Journal of advanced nursing · 2025Article
- Disparities in Access to Vascular Stroke Imaging and Carotid Revascularization: A Population Study.Journal of the American Heart Association · 2025Article
- Effect of SARS-CoV-2 Infection on Endovascular Thrombectomy Outcomes-Data from the Florida Stroke Registry.AJNR. American journal of neuroradiology · 2025Article
- Stroke care in the United Kingdom before, during, and after the COVID-19 lockdowns: A retrospective nationwide cohort study.PloS one · 2025Article
- An Interrupted Time-Series Analysis of the Impact of COVID-19 on Hospitalizations for Vascular Events in 3 Canadian Provinces.CJC open · 2024Article
- Certification of stroke centers at primary hospitals and the improvement of thrombolysis n South China during 2020-2022.European stroke journal · 2024Observational
- Application of radiomics in ischemic stroke.The Journal of international medical research · 2024Review
- Article
- A command centre implementation before and during the COVID-19 pandemic in a community hospital.BMC medical informatics and decision making · 2024Article
- Stroke metrics during the first year of the COVID-19 pandemic, a tale of two comprehensive stroke centers.Scientific reports · 2023Article
- Cerebro-/Cardiovascular Collateral Damage During the COVID-19 Pandemic: Fact or Fiction?Journal of clinical neurology (Seoul, Korea) · 2023Review
- Death as a metric for outcome: Dusk between day and night.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2022Article
- Biosimilar Tenecteplase Versus Alteplase in Acute Ischemic Stroke: A Real World Study.Annals of Indian Academy of NeurologyArticle
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8 authors.
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Abstract
backgroundPandemics may promote hospital avoidance, and added precautions may exacerbate treatment delays for medical emergencies such as stroke. We sought to evaluate ischemic stroke presentations, management and outcomes during the first year of the COVID-19 pandemic.
methodsWe conducted a population-based study, using linked administrative and stroke registry data from Alberta to identify all patients presenting with stroke before the pandemic (Jan. 1, 2016 to Feb. 27, 2020) and in 5 periods over the first pandemic year (Feb. 28, 2020 to Mar. 31, 2021), reflecting changes in case numbers and restrictions. We evaluated changes in hospital admissions, emergency department presentations, thrombolysis, endovascular therapy, workflow times and outcomes.
resultsThe study included 19 531 patients in the prepandemic period and 4900 patients across the 5 pandemic periods. Presentations for ischemic stroke dropped in the first pandemic wave (weekly adjusted incidence rate ratio [IRR] 0.54, 95% confidence interval [CI] 0.50 to 0.59). Population-level incidence of thrombolysis (adjusted IRR 0.50, 95% CI 0.41 to 0.62) and endovascular therapy (adjusted IRR 0.63, 95% CI 0.47 to 0.84) also decreased during the first wave, but proportions of patients presenting with stroke who received acute therapies did not decline. Rates of patients presenting with stroke did not return to prepandemic levels, even during a lull in COVID-19 cases between the first 2 waves of the pandemic, and fell further in subsequent waves. In-hospital delays in thrombolysis or endovascular therapy occurred in several pandemic periods. The likelihood of in-hospital death increased in Wave 2 (adjusted odds ratio [OR] 1.48, 95% CI 1.25 to 1.74) and Wave 3 (adjusted OR 1.46, 95% CI 1.07 to 2.00). Out-of-hospital deaths, as a proportion of stroke-related deaths, rose during 4 of 5 pandemic periods.
interpretationThe first year of the COVID-19 pandemic saw persistently reduced rates of patients presenting with ischemic stroke, recurrent treatment delays and higher risk of in-hospital death in later waves. These findings support public health messaging that encourages care-seeking for medical emergencies during pandemic periods, and stroke systems should re-evaluate protocols to mitigate inefficiencies.
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