The decline in stroke hospitalization due to COVID-19 is unrelated to COVID-19 intensity

Petra Sedova, Julia Anna Kent, Tomas Bryndziar, Jiri Jarkovsky, Ales Tomek, Martin Sramek, Ondrej Skoda, Tereza Sramkova, Kateřina Pokorová, Simona Littnerova, Robert D. Brown, Robert Mikulik

Research output: Contribution to journalArticlepeer-review


Background and Purpose: During the coronavirus disease 2019 (COVID-19) pandemic many countries reported a decline in stroke volumes. The aim of this study was to analyze if the decline was related to the intensity of the COVID-19 pandemic. Methods: The first pandemic year (1 March 2020 to 28 February 2021) overall and during the three COVID-19 waves were compared with the preceding year. Volumes of acute ischaemic stroke (AIS), subarachnoid hemorrhage, intracerebral hemorrhage and recanalization treatments (intravenous thrombolysis [IVT] and mechanical thrombectomy [MT]) were obtained from the National Register of Reimbursed Health Services. Door-to-needle time, onset-to-door time and National Institutes of Health Stroke Scale at admission were obtained from the Registry of Stroke Care Quality. Results: During the pandemic year compared to the preceding year there were 26,453 versus 28,771 stroke admissions, representing an 8.8% decline (p < 0.001). The declines (−10%, −11%, −19%) appeared in COVID-19 waves (spring 2020, autumn 2020, winter 2021) except for an increase (2%) during summer 2020. Admissions for AIS declined by 10.2% (p < 0.001), whilst hemorrhagic stroke volumes were minimally decreased. The absolute volumes of IVT and MT decreased by 9.4% (p < 0.001) and 5.7% (p = 0.16), respectively. However, the proportions of ischaemic stroke patients receiving IVT (18% vs. 18%; p = 0.72) and MT (6% vs. 6%; p = 0.28) remained unchanged. Conclusions: There was a decline in stroke admissions, but such decline was not related to COVID-19 incidence. The frequency of use of recanalization procedures (IVT, MT) and times (onset-to-door time, door-to-needle time) in AIS were preserved in the Czech Republic during the first year of the pandemic.

Original languageEnglish (US)
Pages (from-to)943-950
Number of pages8
JournalEuropean Journal of Neurology
Issue number4
StatePublished - Apr 2023


  • COVID-19
  • Czech Republic
  • intravenous thrombolysis
  • mechanical thrombectomy
  • stroke

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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