09 May COVID Pandemic: Number of Patients Seeking Stroke Care Plummets
MedicalResearch.com Interview with:
Akash Kansagra, MD, MS
Assistant Professor of Radiology
Neurological Surgery, and Neurology
Director, Endovascular Surgical Neuroradiology
Co-Director, Stroke and Cerebrovascular Center
Washington University and Barnes-Jewish Hospital
MedicalResearch.com: What is the background for this study?
Response: Over the past five years, medicine has made enormous strides in stroke treatment. The effectiveness of these therapies has been absolutely astounding, and our ability to get patients to hospitals that can provide this life-saving care has also improved dramatically.
MedicalResearch.com: What are the main findings?
Response: Many stroke experts have been worried by anecdotal reports that stroke patients are seeking care at reduced rates during the pandemic. Our study confirms these fears. By looking at nearly a quarter million patients across virtually the entire United States, we found a staggering 39% decrease in the rate of stroke imaging, a necessary precursor for treatment.
What was perhaps even more surprising was that this decrease affected everyone. The young and the old, minor and severe strokes, men and women, small hospitals and large — all saw remarkable decreases. There were also decreases throughout all geographic regions, including in states that have been less affected by Covid-19.
MedicalResearch.com: What should readers take away from your report?
Response: The main takeaway is that there are substantial collateral effects of the Covid-19 pandemic on care for other acute illnesses, such as stroke.
We must be mindful of these effects. As society works to contain the spread of Covid-19, we must find creative ways to check in on our friends and loved ones even while maintaining physical distance. If anyone has symptoms of a stroke — facial droop, arm weakness, slurred speech, or dizziness — it is important to call 911 immediately.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: In terms of Covid-19 and stroke, there is a need to continue investigating trends in stroke care delivery so we can better understand the enormous impact of Covid-19.
Scientists all over the world are studying Covid-19 in a variety of ways, some in laboratories and others in the field. The type of research we have done here is different. We have repurposed already available data to develop a leading indicator of Covid-19 effects. This kind of data is invaluable to shaping a public health response before it is too late.
MedicalResearch.com: Is there anything else you would like to add?
Response: What really sets this research apart is its scale. Our data is drawn from almost a quarter million patients in nearly one thousand hospitals throughout the United States. This is big data at its finest — our enormously large data set allows us to examine and verify trends in stroke care with far greater reliability and precision than was possible with earlier, anecdotal reports.
I desperately hope that patients understand that social distancing and cancellation of elective medical care throughout the United States and much of the world is not meant to interfere with emergency medical care. If you think you might be having a stroke, get to the hospital as fast as you can. Your life depends on it.
I serve on the medical advisory board of iSchemaView. The company provided the data but was not involved in any way with data analysis, interpretation, or publication. Nevertheless, I do have a very modest relationship with the company.
Thank you so much.
Collateral Effect of Covid-19 on Stroke Evaluation in the United States
May 8, 2020
NEJM: DOI: 10.1056/NEJMc2014816
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