TY - JOUR
T1 - Stringent public health measures during COVID-19 across ischemic stroke care systems
T2 - the potential impact of patient perceptions on health care-seeking behaviors
AU - Prodan, Calin I.
AU - Batra, Ayush
AU - Ungvari, Zoltan
AU - Liotta, Eric M.
N1 - Funding Information:
The authors would like to acknowledge Dr. Fan Z. Caprio from Northwestern University for assistance in obtaining telestroke quality improvement data used for this manuscript. The authors also acknowledge the useful suggestions of Dr. Péter Böjti (Semmelweis University, Budapest) during the preparation of the manuscript.
Funding Information:
Dr. Prodan receives research funding from the US Department of Veterans Affairs (VA CSR&D COVID19-8900–16 and 2 I01 CX000340).
Funding Information:
Dr. Liotta receives research funding from the National Institutes of Health, National Institute of Neurologic Disorders and Stroke (L30 NS098427).
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to American Aging Association.
PY - 2022/6
Y1 - 2022/6
N2 - Decreases in acute stroke presentations have been reported during the coronavirus disease 2019 (COVID-19) pandemic surges. A recent study by Bojti et al. (GeroScience. 2021;43:2231–2248) sought to understand the relationship of public health mandates in Hungary as they were implemented with acute ischemic stroke admissions and interventions during two separate COVID-19 waves. We sought to perform a similar analysis of changes in ischemic stroke care at two distinct medical institutions in the USA. Two separate institutions and systems of ischemic stroke care were evaluated through a regional comprehensive stroke center telestroke service and a Veterans Affairs (VA) inpatient stroke and neurorehabilitation service. Telestroke consultations in a single system in Chicago, IL, were significantly decreased during the first COVID-19 wave during severely restricted public health mandates (z-score < − 2), and were less depressed during a subsequent wave with less severe restrictions (z-score approaching − 1), which resembles findings in Hungary as reported by Bojti et al. In contrast, inpatient admissions during the first and second COVID-19 waves to a VA stroke and neurorehabilitation service in Oklahoma City remained unchanged. The Chicago and Hungary patterns of stroke presentations suggest that public perceptions, as informed by regional health mandates, might influence healthcare-seeking behavior. However, the VA experience suggests that specific patient populations may react differently to given public health mandates. These observations highlight that changes in stroke presentation during the COVID-19 pandemic may vary regionally and by patient population as well as by the severity of public health mandates implemented. Further study of COVID-19-related public health policies on acute stroke populations is needed to capture the long-term impact of such policies. Learning from the real-time impact of pandemic surges and public health policy on presentation of acute medical conditions, such as ischemic stroke, may prove valuable for designing effective policies in the future.
AB - Decreases in acute stroke presentations have been reported during the coronavirus disease 2019 (COVID-19) pandemic surges. A recent study by Bojti et al. (GeroScience. 2021;43:2231–2248) sought to understand the relationship of public health mandates in Hungary as they were implemented with acute ischemic stroke admissions and interventions during two separate COVID-19 waves. We sought to perform a similar analysis of changes in ischemic stroke care at two distinct medical institutions in the USA. Two separate institutions and systems of ischemic stroke care were evaluated through a regional comprehensive stroke center telestroke service and a Veterans Affairs (VA) inpatient stroke and neurorehabilitation service. Telestroke consultations in a single system in Chicago, IL, were significantly decreased during the first COVID-19 wave during severely restricted public health mandates (z-score < − 2), and were less depressed during a subsequent wave with less severe restrictions (z-score approaching − 1), which resembles findings in Hungary as reported by Bojti et al. In contrast, inpatient admissions during the first and second COVID-19 waves to a VA stroke and neurorehabilitation service in Oklahoma City remained unchanged. The Chicago and Hungary patterns of stroke presentations suggest that public perceptions, as informed by regional health mandates, might influence healthcare-seeking behavior. However, the VA experience suggests that specific patient populations may react differently to given public health mandates. These observations highlight that changes in stroke presentation during the COVID-19 pandemic may vary regionally and by patient population as well as by the severity of public health mandates implemented. Further study of COVID-19-related public health policies on acute stroke populations is needed to capture the long-term impact of such policies. Learning from the real-time impact of pandemic surges and public health policy on presentation of acute medical conditions, such as ischemic stroke, may prove valuable for designing effective policies in the future.
KW - Acute stroke population
KW - COVID-19
KW - Health care behaviors
KW - Public health policy
UR - http://www.scopus.com/inward/record.url?scp=85128858671&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85128858671&partnerID=8YFLogxK
U2 - 10.1007/s11357-022-00566-8
DO - 10.1007/s11357-022-00566-8
M3 - Article
C2 - 35467316
AN - SCOPUS:85128858671
VL - 44
SP - 1255
EP - 1262
JO - GeroScience
JF - GeroScience
SN - 2509-2715
IS - 3
ER -
