Stroke admissions reduce as Covid-19 cases rise

Advice to the public during the first wave of the Covid-19 pandemic was to avoid going to hospital unless absolutely necessary, motivated by fears that the NHS would become overwhelmed, ultimately putting more lives at risk.

Elective surgeries were postponed, visiting of inpatients was greatly restricted and people were encouraged to use telephone or online services to contact GPs and other essential services. However, specialists and frontline workers are concerned over the substantial drop in cases noted for some life-threatening condition such as heart attack and stroke

Fern Rodgers, research assistant from PALS and Dr Amir-Homayoun Javadi of University of Kent’s School of Psychology, said: “Stroke admissions dropped (on average) by 40% globally during peak periods of the pandemic, however neither Covid-19 nor lockdown measures have the ability to prevent strokes. In fact, there is evidence that Covid-19 can lead to blood coagulation which increases the likelihood of clotting and thus stroke.”

Staff at University College London Hospital (UCLH) noted a 24.5% reduction in the number of stroke admissions between 1 March and 27 October 2020 compared with the same period last year, and speculated that numbers were down as people avoided coming in for fear of Covid-19; people ‘just coped’ and found their own strategies, and that perhaps some people passed away having not sought help.

They said heightened anxieties around attending hospital due to the risk of contracting Covid-19 on the premises are understandable and with appropriate separation of Covid-positive and non-Covid patients, and even the set-up of Covid-free hospitals in some regions, these chances can be reduced.

It has also been recognised that some people may have been avoiding hospitals so as not to be a ‘burden’ on the NHS, and/or misinterpreting the severity of their symptoms.

“Seemingly, stroke admissions directly relate to Covid-19 cases in a way which may be reflective of public anxieties. A marked drop in total stroke admissions between January and June 2020 (compared to the previous year) was observed at the Northwick Park HyperAcute Stroke Unit (HASU), with the greatest reductions in admissions mirroring the greatest first peak of confirmed Covid-19 cases nationally. As viral admissions decreased, this mirroring was noticed again, with stroke admissions increasing and trending towards normal levels. We hypothesise that this pattern will be observed again in future ‘waves’ of virus prevalence in the community.

“Pandemic or no pandemic, stroke poses a very real threat to health, wellbeing and quality of life, and if left untreated can be significantly more damaging in both the short and the long term. It is of paramount importance that if individuals suspect they, or someone they are with, may be having a stroke, they do not hesitate in seeking help.”

Commenting on the issue Dr Rudi Coetzer from Bangor University said: “Individuals who have suffered a Stroke, need not fear that they will “put a strain on the hospital”, or try to minimise their symptoms – Stroke care and rehabilitation continues, albeit in a slightly different way.”

The researchers are conducting further research into individuals’ experiences with strokes since March 2020. A survey can be accessed via this link, for those who would like to share their experiences: http://bit.ly/stroke-survey

Links

• UCL Division of Psychology and Language Sciences 
• Fern Rodgers 
• Dr Amir-Homayoun Javadi