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Multifactorial Predictors of Late Epileptic Seizures Related to Stroke: Evaluation of the Current Possibilities of Stratification Based on Existing Prognostic Models—A Comprehensive Review
Open AccessArticle

Changes in Prehospital Stroke Care and Stroke Mimic Patterns during the COVID-19 Lockdown

1
Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
2
J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02109, USA
3
Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania
4
Department of Neurology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-094 Bydgoszcz, Poland
5
Department of Neurology, Astana Medical University, Nur-Sultan 010000, Kazakhstan
6
Center of Neurology, Vilnius University, 08661 Vilnius, Lithuania
*
Author to whom correspondence should be addressed.
Co-first authorship.
Academic Editors: Claudia Altamura, Altavilla Riccardo, Maggio Paola and Palazzo Paola
Int. J. Environ. Res. Public Health 2021, 18(4), 2150; https://doi.org/10.3390/ijerph18042150
Received: 25 January 2021 / Revised: 16 February 2021 / Accepted: 18 February 2021 / Published: 23 February 2021
(This article belongs to the Special Issue Prevention and Treatment of Cerebrovascular Diseases)
The impact of COVID-19 lockdown on prehospital stroke care is largely unknown. We aimed to compare stroke care patterns before and during a state-wide lockdown. Thus, we analysed prospective data of stroke alerts referred to our stroke centre between 1 December 2019 and 16 June 2020, and compared them between two periods—15 weeks before and 13 weeks during the state-wide lockdown declared in Lithuania on 16 March 2020. Among 719 referrals for suspected stroke, there was a decrease in stroke alerts (rate ratio 0.61, 95% CI (0.52–0.71)), stroke admissions (0.63, 95% CI (0.52–0.76)), and decrease in prehospital stroke triage quality (positive predictive value 72.1% vs. 79.9%, p = 0.042) during the lockdown. The onset-to-door time was longer (153.0 vs. 120.5 min, p = 0.049) and seizures and intracranial tumours were more common among stroke mimics (16.9% vs. 6.7%, p = 0.012 and 9.6% vs. 3.0%, p = 0.037, respectively). We conclude that there was a decline in prehospital stroke triage quality during the lockdown despite low COVID-19 incidence in the country. Moreover, we observed an increase in hospital arrival delays and severe conditions presenting as stroke mimics. Our findings suggest that improved strategies are required to maintain optimal neurological care during public health emergencies. View Full-Text
Keywords: COVID-19; emergency medical services; stroke; misdiagnosis; stroke mimic; triage COVID-19; emergency medical services; stroke; misdiagnosis; stroke mimic; triage
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MDPI and ACS Style

Melaika, K.; Sveikata, L.; Wiśniewski, A.; Jaxybayeva, A.; Ekkert, A.; Jatužis, D.; Masiliūnas, R. Changes in Prehospital Stroke Care and Stroke Mimic Patterns during the COVID-19 Lockdown. Int. J. Environ. Res. Public Health 2021, 18, 2150. https://doi.org/10.3390/ijerph18042150

AMA Style

Melaika K, Sveikata L, Wiśniewski A, Jaxybayeva A, Ekkert A, Jatužis D, Masiliūnas R. Changes in Prehospital Stroke Care and Stroke Mimic Patterns during the COVID-19 Lockdown. International Journal of Environmental Research and Public Health. 2021; 18(4):2150. https://doi.org/10.3390/ijerph18042150

Chicago/Turabian Style

Melaika, Kazimieras; Sveikata, Lukas; Wiśniewski, Adam; Jaxybayeva, Altynshash; Ekkert, Aleksandra; Jatužis, Dalius; Masiliūnas, Rytis. 2021. "Changes in Prehospital Stroke Care and Stroke Mimic Patterns during the COVID-19 Lockdown" Int. J. Environ. Res. Public Health 18, no. 4: 2150. https://doi.org/10.3390/ijerph18042150

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