Impact of COVID-19 on Acute Stroke Care

The COVID-19 pandemic precipitated profound disruptions in acute stroke services worldwide. Many centres reported substantial reductions in patient presentations, with declines especially marked for mild strokes and transient ischaemic attacks. Fears of viral exposure, public health restrictions and reallocation of resources contributed to delays in symptom recognition, ambulance activation and in-hospital workflows. Where stroke admissions persisted, patients often exhibited greater severity on arrival. Treatment pathways adapted rapidly: some centres streamlined imaging protocols, others restructured stroke teams to maintain timeliness of reperfusion therapies. Telemedicine networks expanded to support prehospital triage and outpatient follow-up. Although overall volumes fell during peak waves, recovery in stroke admissions and treatment rates typically followed the introduction of targeted guidelines, highlighting the resilience and adaptability of stroke systems in the face of global health emergencies.

Research from Nature Portfolio

A large retrospective study across multiple urban stroke centres compared acute ischaemic stroke admissions and care parameters in the year before versus during the pandemic. Admission volumes fell by nearly a quarter, but proportions of patients receiving intravenous thrombolysis and endovascular treatment increased modestly. Notably, door-to-needle and door-to-thrombectomy times were prolonged during peak restrictions, especially in high-risk areas. Once consensus protocols were disseminated, treatment delays diminished and admission rates began to recover, underscoring the importance of rapid deployment of context-specific clinical pathways.

Impact of COVID-19 on Acute Stroke Care publication trend

The graph below shows the total number of articles in impact of covid-19 on acute stroke care across all publications each year (not limited to Nature Index journals).

Technical terms

Acute ischaemic stroke: Sudden loss of blood flow to a brain region due to arterial occlusion, leading to neuronal injury.

Intravenous thrombolysis: Administration of clot-dissolving agents through a peripheral vein to restore cerebral perfusion.

Endovascular treatment: Mechanical removal of intra-arterial clots using catheter-based devices.

Door-to-needle time: Interval between hospital arrival and initiation of intravenous thrombolysis.

Mechanical thrombectomy: Endovascular procedure using specialized devices to extract obstructive thrombi from cerebral arteries.

References

1. Impact of the COVID-19 pandemic on emergent stroke care in Beijing, China. Scientific Reports (2023).
2. Changes in stroke and TIA admissions during the COVID-19 pandemic: A meta-analysis. European Stroke Journal (2023).
3. Global impact of COVID-19 on stroke care. International Journal of Stroke (2021).