Study suggests stroke evaluations plummet during COVID-19 pandemic

May 13, 2020

A study has found that stroke evaluations fell by nearly 40 percent during a two-week period after the U.S. declared a COVID-19 public emergency, suggesting that many stroke patients are not seeking potentially life-saving medical treatment, according to a news release from the Washington University School of Medicine in St. Louis.

The findings were published May 8 in The New England Journal of Medicine.

When patients arrive at a hospital and are showing signs of a stroke, they often get a brain scan, and many hospitals use software known as RAPID to analyze such a brain scan.

To measure the change in the number of stroke evaluations done at U.S. hospitals, researchers assessed how often the RAPID software was used in February, before the pandemic, and during a two-week period from March 26 to April 8, when much of the country was under shelter-in-place orders.

In total, the software was used for 231,753 patients at 856 hospitals representing the District of Columbia and all 50 states except New Hampshire. During February, the software was used for an average of 1.18 patients per day per hospital. During the pandemic period, software use per hospital averaged 0.72 patients per day, a drop of 39 percent.

“Our stroke team has maintained full capacity to provide emergency stroke treatment at all times, even during the height of the pandemic,” said lead author Akash Kansagra, MD, an assistant professor of radiology at Washington University’s Mallinckrodt Institute of Radiology (MIR), who sees stroke patients at Barnes-Jewish Hospital. “Nevertheless, we have seen a smaller number of stroke patients coming to the hospital and some patients arriving at the hospital after a considerable delay. It is absolutely heartbreaking to meet a patient who might have recovered from a stroke but, for whatever reason, waited too long to seek treatment.”

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