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논문 기본 정보

자료유형
학술저널
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Noman Ishaque (Division of NeurologyDivision of Neurology University of Alberta Edmonton AB Canada) Asif Javed Butt (Division of Neurology Department of Medicine University of Alberta Edmonton AB Canada) Joseph Kamtchum-Tatuene (Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada) Ali Zohair Nomani (Division of Neurology Department of Medicine University of Alberta Edmonton AB Canada) Sarah Razzaq (Department of Medicine Fatima Jinnah Medical University Lahore Pakistan) Nida Fatima (Department of Neurosurgery Massachusetts General Hospital Harvard Medical School) Chetan Vekhande (Division of Neurology Department of Medicine University of Alberta Edmonton AB Canada) Radhika Nair (Division of Neurology Department of Medicine University of Alberta Edmonton AB Canada) Naveed Akhtar (Division of Neurology Department of Medicine Hamad General Hospital Doha Qatar) Khurshid Khan (Division of Neurology Department of Medicine University of Alberta Edmonton AB Canada) Maher Saqqur (Department of Neurology Trillium Health Care University of Toronto Mississauga ON Canada) Ashfaq Shuaib (Division of Neurology Department of Medicine University of Alberta Edmonton AB Canada)
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대한뇌졸중학회 대한뇌졸중학회지 대한뇌졸중학회지 제24권 제1호
발행연도
2022.1
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65 - 78 (14page)

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Background and Purpose There are reports of decline in the rates of acute emergency presentations during coronavirus disease 2019 (COVID-19) pandemic including stroke. We performed a meta-analysis of the impact of COVID-19 pandemic on rates of stroke presentations and on rates of reperfusion therapy. Methods Following the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines, we systematically searched the literature for studies reporting changes in stroke presentations and treatment rates before and during the COVID-19 pandemic. Aggregated data were pooled using meta-analysis with random-effect models. Results We identified 37 observational studies (n=375,657). Pooled analysis showed decline in rates of all strokes (26.0%; 95% confidence interval [CI], 22.4 to 29.7) and its subtypes; ischemic (25.3%; 95% CI, 21.0 to 30.0), hemorrhagic (27.6%; 95% CI, 20.4 to 35.5), transient ischemic attacks (41.9%; 95% CI, 34.8 to 49.3), and stroke mimics (45.6%; 95% CI, 33.5 to 58.0)during months of pandemic compared with the pre-pandemic period. The decline was most evident for mild symptoms (40% mild vs. 25%?29% moderate/severe). Although rates of intravenous thrombolytic (IVT) and endovascular thrombectomy (EVT) decreased during pandemic, the likelihood of being treated with IVT and EVT did not differ between the two periods, both in primary and in comprehensive stroke centers (odds ratio [OR], 1.08; 95% CI, 0.94 to 1.24 and OR,0.95; 95% CI, 0.83 to 1.09, respectively). Conclusions Rates of all strokes types decreased significantly during pandemic. It is of paramount importance that general population should be educated to seek medical care immediately for stroke-like symptoms during COVID-19 pandemic. Whether delay in initiation of secondary prevention would affect eventual stroke outcomes in the long run needs further study.

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