(Open access funding provided by Semmelweis University)
Data about the coronavirus disease 2019 (COVID-19) pandemic's collateral damage on
ischemic stroke (IS) care during the second epidemic wave in Central Europe are limited.
We sought to evaluate the impact of the COVID-19 outbreak on Hungarian IS care during
the two epidemic waves. This retrospective observational study was based on a nationwide
reimbursement database that encompasses all IS admissions and all reperfusion interventions,
i.e., intravenous thrombolysis (IVT) and endovascular therapy (EVT) from 2 January
2017 to 31 December 2020 in Hungary. COVID-19 pandemic's effect on the number of IS
admissions and reperfusion interventions were analyzed using different statistics:
means, medians, trends, relative rates, and linear relationships. The mean and median
values of IS admissions and reperfusion interventions decreased only in some measure
during the COVID-periods. However, trend analysis demonstrated a significant decline
from the trends. The decline's dynamic and amplitude have differed for each variable.
In contrast to IVT, the number of IS admissions and EVTs negatively correlated with
the epidemic waves' amplitude. Besides, the decrease in the number of IS admissions
was more pronounced than the decrease in the number of reperfusion interventions.
Our study demonstrated a significant disruption in IS care during the COVID-19 epidemic
in Hungary, in which multiple different factors might play a role. The disproportionate
reduction of IS admission numbers could partially be explained by the effect of health
emergency operative measures and changes in patients' social behavior. Further studies
are needed to evaluate the causes of our observations.
