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Título

STROKE PROFILE AND CARE DURING THE COVID-19 PANDEMIC: THE JOINVILLE'S FIRST YEAR EXPERIENCE.

Resumo

INTRODUCTION: The SARS-CoV-2 coronavirus pandemic (COVID-19) has become one of the hardest challenges nowadays. Public managers and health teams have concerned about social restrictions, lack of resources and a possible negative impact on incidence and quality of care for Stroke patients. OBJECTIVE: We aim to investigate the impact of COVID-19 on incidence and management of Transient Ischemic Attack (TIA), Stroke and its subtypes in Joinville, Brazil. METHODS: We did a prospective population-based stroke registry of all first-ever cases of Transient Ischemic Attack (TIA), Stroke and its subtypes admitted to health services in Joinville since the beginning of restrictions due to COVID-19 (defined as March, 2020) and the same period one year before. A comparative analysis was made between these two periods (12 months before versus 12 months after COVID-19 outbreak) . The patients'profile, incidences of TIA, stroke and its subtypes, severity, reperfusion therapies, in-hospital stay and workout and in-hospital lethality in these periods were compared. RESULTS: The analysis showed a significant incidence reduction of TIAs (32,8%; p=0,002). The rate of thrombolysis (IV) and trombectomy (MT) did not change. The intervals from admission to IV/MT were similar in both periods. Patients with ischemic stroke caused by atrial fibrilation had their in-hospital stay abbreviated during the pandemic. Workout investigation was similar before and during the pandemic, with an increase in number of Cranial Tomography (p=0.02), transtoracic ecocardiogram (p=0.001), chest X-rays (p<0.001) and Transcranial Dopplers (p <0.001). During COVID-19 pandemics, in-hospital lethality did not change. CONCLUSION: We concluded that COVID-19 Pandemic in Joinville was associated with lower TIA incidence, without negative influence over quality of care, workout investigation and in-hospital management of stroke patients. Studies are needed to understand the real reasons for this epidemiological behavior. We believe that fast and strategic response to unusual pandemic challenges can explain good results e minor hazards in stroke prevention and caring.

Palavras Chave

STROKE; COVID-19; INCIDENCE; LETHALITY; QUALITY OF ASSISTANCE.