Impact Of Covid-19 Pandemic On Stroke Care At The University Of Rochester Medical Center.

Introduction: The impact of the COVID-19 pandemic response on medical care for stroke is unknown Methods: We used local “Get With The Guidelines” stroke data for patients with ischemic stroke (IS), transient ischemic attack (TIA), and intracerebral hemorrhage/subarachnoid hemorrhage (ICH/SAH) from March 20-April 14, 2020 (study period) and January 1-March 19, 2020 (control period #1) and March 20-April 14, 2019 (control period #2) We examined daily admission rates, transfers, tPA administration, thrombectomy, and time from last well to hospital arrival Results: There were 349 patients (n=40 study period, n=225 control period #1, n=84 control period #2);263 with IS, 37 with TIA, and 49 with ICH/SAH Overall, 46% were female, 82% white, with median age 70 years (IQR 58-82 years) Daily admission rates were 1 4 IS/day for the study period compared to 2 1 IS/day (Incident rate ratio [IRR] 1 49 95% CI 1 05-2 13, p=0 027) and 2 2 IS/day (IRR 1 57 1 04-2 37, p=0 033) for control periods #1 and #2 (Table), respectively There was only one admission for TIA in the study period compared to approximately one every 4 days in control period #1 (IRR 7 2 95% CI 1 0-53 7, p=0 053) and one every 2 days in control period #2 (IRR 14 0 95% CI 1 8-106 5, p=0 011) ICH/SAH admissions were fewer in the study period Transfers were less common with approximately one transfer every four days in the study period compared to one each day of the control periods Rates of tPA, thrombectomy, and time from last well to first hospital contact did not differ across the epochs Conclusions: Our data suggest the COVID-19 pandemic response has led to reduced admissionvolumes for all stroke types in the University of Rochester Medical Center catchment area, partlydue to decreases in hospital transfers These data raise the question whether fewer patients soughtcare for stroke symptoms at the height of the COVID-19 pandemic