Fewer Stroke Cases Reported During First COVID-19 Wave

Alberta sees increase in out-of-hospital stroke deaths in COVID-19 Waves 2 and 3.

Fewer hospital visits during the first year of the COVID-19 pandemic were seen for stroke, stroke therapies. However, more treatment delays and increased risk of in-hospital deaths were seen in the subsequent COVID-19 waves.

The Alberta //study was published in CMAJ (Canadian Medical Association Journal).

Nausea Drugs Linked to Heightened Stroke Risk
Antidopaminergic antiemetics (ADAs) that are widely used to ease nausea and vomiting are associated with a higher risk of ischemic stroke.

‘Alberta sees increase in out-of-hospital stroke deaths in COVID-19 Waves 2 and 3.’

"It is unlikely that the observed reductions in patients presenting to hospital with stroke reflect true declines in stroke occurrence, and more likely that it reflects pandemic-related hospital avoidance, as reported for other emergencies," writes Dr. Aravind Ganesh, University of Calgary, Calgary, Alberta, with coauthors.

Researchers looked at data on 19 531 patients in Alberta during the prepandemic period (January 1, 2016, to February 27, 2020) and 4900 patients across the five pandemic phases from February 28, 2020, to March 31, 2021.

According to World Stroke Organization data, hospital visits and admissions for ischemic stroke decreased in Wave 1 compared with the prepandemic period, rebounded somewhat during the lull before Wave 2 and declined further in Wave 3.

New Virtual Stroke Rehabilitation Method
Researchers found that game-based therapy led improves stroke rehabilitation outcomes.

Treatments for stroke, such as thrombolysis and endovascular therapy, also declined compared with the prepandemic period.

As SARS-CoV-2 positivity is associated with subsequent cardiovascular issues, emergency departments would be expected to see more cases of heart disease and stroke in later waves.

High Blood Fat Levels Give Second Chance to Stroke
A new study shows an association between high triglyceride levels and the risk of the second stroke even in people taking drugs to lower blood fats.

"Especially during the second- and third-wave periods of our study, when COVID-19 cases surged, we expected to observe an increase in stroke presentations instead of declines," the researchers write.

Study authors noted a substantial increase in out-of-hospital stroke deaths as a proportion of all stroke-related deaths in the province during the pandemic periods.

Optimism Linked to Lower Stroke Severity
Optimistic people have a better disease outcome, reduced inflammation, thus boosting morale may be an ideal way to improve mental health and recovery after a stroke, stated new study.

The study provides additional evidence of the pandemic's effect on medical emergencies such as strokes. Data from Spain showed a decrease of 40% or more in admissions for myocardial infarction and stroke, and preliminary reports from Italy showed a 25% drop in admissions for stroke and a 14% drop in thrombolysis to treat stroke.

"We have shown not only that the early COVID-19 pandemic was associated with decline in presentations for ischemic stroke and use of acute therapies, even after adjustment for confounding variables, but that these problems persisted in later waves," write the authors.

"Importantly, the lower population-level incidence of thrombolysis and endovascular therapy appeared to reflect declines in stroke presentations rather than any therapeutic inertia."

Public health messaging should encourage patients to seek care for emergencies, even during a pandemic.

Source-Eurekalert