Open AccessStroke Hospital Admissions during the COVID-19 Outbreak in São Paulo, Brazil
Author(s) -
Laura Silveira Tanisaka,
Laércio da Silva Paiva,
Luís Eduardo Werneck de Carvalho,
Fernando Luiz Affonso Fonseca,
David Feder,
Vânia Barbosa do Nascimento,
Fernando Adami
Publication year - 2022
Publication title -
cerebrovascular diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 104
eISSN - 1421-9786
pISSN - 1015-9770
DOI - 10.1159/000521794
Subject(s) - medicine , stroke (engine) , intracerebral hemorrhage , emergency medicine , public health , covid-19 , pediatrics , health care , outbreak , demography , medical emergency , disease , subarachnoid hemorrhage , infectious disease (medical specialty) , mechanical engineering , nursing , virology , sociology , engineering , economics , economic growth
Background: Globally, stroke remains an important cause of death and long-term disability, and the impact of coronavirus disease (COVID-19) on the health system may have impaired stroke care. Previous studies suggest significant reduction in hospital admissions for stroke after COVID-19 onset as patients may hesitate seeking medical help due to fear of exposure. Methods: This cross-sectional study included cases of hospital admissions for stroke, identified from the Hospital Information System of the Unified Health System (Sistema Único de Saúde), which contains official and public data in Brazil. Data were collected in duplicate, then categorized according to the International Classification of Diseases, tenth revision (ICD-10), considering codes I60–I69. Linear regression was used to estimate the variation in hospital admissions for stroke in the city of São Paulo (SP) – the largest and most populous city in Brazil and Latin America, between January and June of each analyzed year (2017–2020). The percentage variation between June and January 2020 was also compared. The level of significance was set at 5%, and the statistical program used was Stata, version 14.0. Results: In the city of SP, during the first wave of COVID-19, from January to June 2020, there were registered decreases in absolute numbers and mean monthly admissions for stroke. Compared to January 2020, data from June 2020 showed 17% reduction in hospitalizations for intracerebral hemorrhage, 32% for cerebral infarction, 26% for stroke unspecified, and 47% for other cerebrovascular diseases. Conclusion: We argue for policies aimed at improving stroke care and developing awareness campaigns regarding the importance of early diagnosis and treatment, as even in less severe presentations, stroke can trigger an increase in mortality, cost, and long-term disability.