Ischemic stroke patients are showing up to the hospital an average of 160 minutes later during the COVID-19 pandemic than during a similar timeframe in 2019, according to a new study.
The delay is affecting both stroke survival and recovery, add stroke surgeons from the Society of NeuroInterventional Surgery (SNIS).
The first study to confirm suspected stroke patient avoidance assessed 710 patients presenting with acute ischemic strokes at 12 stroke centers across six states. It compared the period of February and March 2019 (the baseline period) to February 2020 (the “pre-COVID-19” period) and March 2020 (the “COVID-19” period). In addition to the delay in treatment, the study also found a marked decrease in overall reported stroke patients, from 223 to 167, in these same treatment centers from February to March 2020 with the onset of the COVID-19 pandemic. It was published in the Journal of NeuroInterventional Surgery (JNIS).
In the most serious strokes — known as an emergent large vessel occlusions — up to 2 million brain cells die each minute, according to neurointerventionalists with the society’s Get Ahead of Stroke campaign. The longer patients wait before treatment, the greater the impact the stroke can have. Additionally, for every minute lost before receiving appropriate care, there is an associated medical cost of $1,000 for short- and long-term care, the doctors noted. A 160-minute delay amounts to the loss of 320 million brain cells and $160,000 in additional medical costs.
“When it comes to stroke treatment, every minute counts. My colleagues and I have been devastated to see patients arriving at the hospital too late for us to help them,” said lead author Dr. Clemens Schirmer of Geisinger Medical Center in Danville, Pa., in a news release. “Our findings indicate a dire need for public education to address COVID-19-related fears to ensure people with stroke symptoms seek the lifesaving care they need without delay.”
Hospitals and medical clinics have put strategies in place to prevent COVID-19 infection. The American Heart Association’s Stroke Council recently released new guidelines urging the use of telemedicine to speed treatment of stroke patients and advise EMS crews how to determine the best facility to treat the patient’s needs.
“Even during the COVID-19 pandemic, patients should continue to seek immediate care for life-threatening and emergency conditions, and call 911 for any new signs or symptoms of stroke,” said University of Virginia Health stroke expert Dr. Andrew Southerland, one of the guidelines’ authors. “Seeking emergency care for a stroke can help save lives and reduce the risk of long-term neurologic injury and resulting disability.”
The stroke patients’ behavior is at odds with the results of a new Gallup poll, which found fewer Americans are worried about going to the doctor amid the COVID-19 pandemic. Gallup found 22% of Americans during the May 14–24 time period were very concerned about COVID-19 exposure during a visit to a doctor’s office or hospital, down more than 20 percentage points from the 44% registered March 28–April 6.
“Stroke care teams across the country have implemented protocols to safeguard patients from COVID-19,” said SNIS president Dr. Richard P. Klucznik. “A stroke will not go away if you ignore it, and delaying treatment could eliminate your chance for recovery. It’s critical to pay attention to any symptoms of stroke and call 911 right away.”