Impact Of The Covid-19 Pandemic In Houston On Stroke Care In A Health System Of 10 Stroke Centers

Introduction: We assessed the impact of COVID-19 pandemic on stroke admissions and care metrics within a health system of 10 stroke centers, with 4 comprehensive stroke centers (CSC) in the greater Houston region Methods: Between January-June 2019 and January-June 2020, we compared the proportion of ischemic strokes (total \u0026 direct CSC presentations) \u0026 intracerebral hemorrhage (ICH) relative to total admissions using logistic regression, and among the direct CSC presentations, we compared door to tPA and thrombectomy times using Wilcoxon Rank Sum Results: A total of 4808 cases were assessed (Table 1) There was an initial drop of ∼30% in cases at the pandemic onset (Fig 1) Numerically fewer patients in the 2020 period were seen at primary and CSCs (Table 1) Compared to 2019, there was a significant reduction in transferred patients [N(%), 829 (36) vs 637 (34), p=0 02], in hospital strokes [N(%), 111 (5) vs 69 (4), p=0 04], and mild strokes (NIHSS 1-5) [N (%), 891 (43) vs 635 (40),p=0 02], and no significant differences in the proportions of total ischemic strokes [OR (95% CI)=0 92 (0 79, 1 06), p=0 23], direct CSC presentations [OR (95% CI) =0 96 (0 86, 1 08), p=0 48] and ICH [OR (95% CI) =1 14 (0 98, 1 33), p=0 08] in 2020 (Fig 1) Among the direct ischemic strokes at CSCs, there were similar mean (SD) (mins) door to tPA [44 (17) vs 42 (17), p=0 14] but significantly prolonged door to thrombectomy times [94 (15) vs 85 (20), p=0 005] in 2020 Conclusion: COVID-19 pandemic led to reduced mild stroke admissions, transfers and in hospital stroke alerts, \u0026 prolonged door to thrombectomy times Identifying reasons to mitigate this discrepancy is crucial for next pandemic preparedness (Figure Presented)