A comparative time matched hospital based study of first ever stroke patients admitted to stroke unit during pre-COVID 19 vs COVID 19 pandemic era

To study effects of COVID 19 pandemic era on demographics, type and severity of strokes, morbidity & mortality among patients having first ever stroke who were admitted to stroke unit during similar months(April & May) in year 2019 & 2020. To study the effects of COVID 19 pandemic era on diagnosis of minor strokes and utilization of imaging modalities(MRI/NCCT). Retrospective Study. The study was conducted at GMC Kota, a tertiary care hospital in Rajasthan. All patients having their first ever stroke and admitted to our stroke unit during the pre-COVID 19 period (April 2019-May 2019) and the COVID 19 period (April 2020-May 2020) were considered. The characteristics of stroke, the severity, the number of admissions per day, and demographic characteristics as well as the short-term outcomes were studied. Biostatistician was consulted for statistical analysis. Descriptive statistics, Shapiro-Wilk test, means with standard deviation, Chi-square test, Fisher’s exact test, Linear and logistic regression were used as per data characteristics and requirement. P-value of <.05 was considered significant. Of the 108 patients included, 44 (40.7%) presented during the COVID-19 period. There was a 36% reduction in first-ever stroke diagnoses from (1.05/day) to (0.72/day) (p<.0001). The admitted patients were five years older and in much worse health than in the pre-COVID 19 era (p<.0001). There was a statistically significant reduction in MRI use by 27% (p=0.055). The observation suggests an overall reduced number of stroke admissions per day. Patients admitted were older and more severely ill. In COVID 19 era patients, mortality and mRS at admission and discharge were higher, along with a longer hospital stay. An overall reduction in the utilization of MRI was observed due to COVID protocol.