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Papers of the Week

2020 Sep 27

JMIR Aging

Decrease in Strokes during SARS-CoV-2 Pandemic: Where Did All Our Stroke Patients Go?


Dula A N, Gealogo Brown G, Aggarwal A, Clark KL
JMIR Aging. 2020 Sep 27.
PMID: 33006936.


Despite the evidence to suggest a high rate of cerebrovascular complications in patients with SARS-CoV-2, reports indicate a falling rate of new ischemic stroke diagnoses. An observed decrease in emergency department visits should come as no shock during times of major crises, as patients prioritize avoiding exposure to SARS-CoV-2 against the acute situation that they may perceive as mild symptoms of a headache, lethargy, difficulty speaking, and numbness. In the central and south Texas regions where we practice, we suspect that patient admission, treatment, and discharge volumes for acute stroke treatment have decreased significantly since COVID-19 related shelter-at-home orders were issued. Symptoms of stroke are frequently noticed by another family member, friend, or community member before they are recognized by the patients themselves, and perhaps these symptoms are going unnoticed due to limited face-to-face encounters. This emphasizes the importance of patient education on stroke warning signs and symptoms during the current times of isolation and social-distancing. The central Texas population, already saddled with above-average rates of cardiovascular and cerebrovascular disease, has a higher stroke mortality rate compared to Texas and U.S. averages; however, the number of patients presenting to emergency departments with acute ischemic stroke diagnoses are lower than average. Our viewpoint aims to present the relative literature to-date and outline our ongoing analyses in the highly-affected and diverse stroke populations from San Antonio and Austin, TX. To put it simply: where did all our stroke patients go?