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Greater decline of acute stroke admissions compared with acute coronary syndromes during COVID‐19 outbreak in Greece: Cerebro/cardiovascular implications amidst a second wave surge
Author(s) -
Katsouras Christos,
Karapanayiotides Theodoros,
Papafaklis Michail,
Giannopoulos Sotirios,
Ziakas Antonios,
Sianos George,
Papagiannopoulou Georgia,
Koutroulou Ioanna,
Varytimiadi Eythimia,
Kosmidou Maria,
Naka Katerina,
Michalis Lampros K.,
Tsivgoulis Georgios
Publication year - 2021
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.14666
Subject(s) - medicine , stroke (engine) , incidence (geometry) , outbreak , population , emergency medicine , acute coronary syndrome , rate ratio , case fatality rate , covid-19 , pandemic , mortality rate , pediatrics , demography , epidemiology , myocardial infarction , environmental health , disease , virology , mechanical engineering , physics , infectious disease (medical specialty) , optics , engineering , sociology
Background and purpose A remarkable decline in admissions for acute stroke and acute coronary syndrome (ACS) has been reported in countries severely hit by the COVID‐19 pandemic. However, limited data are available from countries with less COVID‐19 burden focusing on concurrent stroke and ACS hospitalisation rates from the same population. Methods The study was conducted in three geographically and demographically representative COVID‐19 referral university hospitals in Greece. We recorded the rate of stroke and ACS hospital admissions during a 6‐week period of the COVID‐19 outbreak in 2020 and compared them with the rates of the corresponding period in 2019. Results We found a greater relative reduction of stroke admissions (51% [35 vs. 71]; incidence rate ratio [IRR]: 0.49, p = 0.001) compared with ACS admissions (27% [123 vs. 168]; IRR: 0.73, p = 0.009) during the COVID‐19 outbreak ( p = 0.097). Fewer older (>65 years) patients (stroke: 34.3% vs. 45.1%, odds ratio [OR]: 0.64, p = 0.291; ACS: 39.8% vs. 54.2%, OR: 0.56, p = 0.016) were admitted during the COVID‐19 compared with the control period. Conclusions Hospitalisation rates both for stroke and ACS were reduced during the COVID‐19 outbreak in a country with strict social distancing measures, low COVID‐19 incidence and low population mortality. Lack of triggers for stroke and ACS during social distancing/quarantining may explain these observations. However, medical care avoidance attitudes among cerebro/cardiovascular patients should be dissipated amidst the rising second COVID‐19 wave.