Risk of contracting SARS-CoV-2 (COVID-19) from hospital admission and the impact of protection efforts on acute stroke treatment

Abstract

\n Background\n It is unclear how interventions designed to restrict community and in-hospital exposure to the SARS-CoV-2 (COVID-19) virus influenced stroke care for patients seeking acute treatment. Therefore, we aimed to determine COVID-19 intervention impact on acute stroke treatment times and assess risk of contracting COVID-19 due to their stay in our medical center.\n \n Methods\n Retrospective, single center, two-phase study evaluating hospital and community trends from 12/2019 – 04/2020 compared to the previous year and pre/post (n=156/93) intervention implementation. Phase I assessed stroke treatment times, delay to hospital arrival, and witnessed stroke volume. Phase II, a post-implementation telephone survey, assessed risk of developing symptoms or testing positive for COVID-19.\n \n Results\n Stroke volume declined by 29% (p<.05) from April to March compared to the previous year. However, no significant delays in seeking medical care (pre Mdn=112, post Mdn=95, p=.34) was observed. Witnessed stroke volume decreased 11% (p<.001) compared to the pre-implementation group, but no significant delay in IV alteplase (pre Mdn=22mins; post Mdn=26mins, p=.08) nor endovascular treatment (pre Mdn=60mins; post Mdn=80mins, p=.45) was observed. In Phase II, 63 patients participated, two tested (3%) COVID-19 positive during admission and four (6%) within two weeks of discharge. COVID-19 contraction risk during and after hospitalization remained similar to the general population (RR=1.75, 95%CI: 0.79-3.63). Overall results indicated a marked decrease in stroke volume, no significant delays to either seek or provide acute stroke care were evident, and COVID-19 contraction risk was low.\n \n Conclusions\n Seeking acute stroke medical care outweighs the risk of COVID-19 exposure.\n