Volume 28, Issue 10 pp. 3452-3455
SHORT COMMUNICATIONS

Greater decline of acute stroke admissions compared with acute coronary syndromes during COVID-19 outbreak in Greece: Cerebro/cardiovascular implications amidst a second wave surge

Christos Katsouras

Christos Katsouras

2nd Department of Cardiology, University Hospital of Ioannina, University of Ioannina, Ioannina, Greece

Contribution: Conceptualization (supporting), Writing - original draft (equal)

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Theodoros Karapanayiotides

Corresponding Author

Theodoros Karapanayiotides

2nd Department of Neurology, Faculty of Health Sciences, School of Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

Correspondence

Theodoros Karapanayiotides, 2nd Department of Neurology, AHEPA University Hospital, S.Kyriakidi 1, 54636, Thessaloniki, Greece.

Email: [email protected]

Contribution: Conceptualization (equal), Methodology (equal), Project administration (equal), Writing - original draft (equal)

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Michail Papafaklis

Michail Papafaklis

2nd Department of Cardiology, University Hospital of Ioannina, University of Ioannina, Ioannina, Greece

Contribution: Data curation (equal), Formal analysis (equal), ​Investigation (equal)

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Sotirios Giannopoulos

Sotirios Giannopoulos

Department of Neurology, University Hospital of Ioannina, University of Ioannina, Ioannina, Greece

Contribution: Conceptualization (lead), Supervision (lead), Validation (equal), Visualization (lead), Writing - review & editing (equal)

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Antonios Ziakas

Antonios Ziakas

Department of Cardiology, Faculty of Medicine, School of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

Contribution: Data curation (equal), ​Investigation (equal), Methodology (equal)

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George Sianos

George Sianos

Department of Cardiology, Faculty of Medicine, School of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

Contribution: Data curation (equal), Formal analysis (equal), ​Investigation (equal)

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Georgia Papagiannopoulou

Georgia Papagiannopoulou

2nd Department of Neurology, ATTIKON University Hospital, National and Kapodistrian University of Athens, Athens, Greece

Contribution: Data curation (equal), Formal analysis (equal), ​Investigation (equal), Methodology (equal)

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Ioanna Koutroulou

Ioanna Koutroulou

2nd Department of Neurology, Faculty of Health Sciences, School of Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

Contribution: Data curation (equal), Formal analysis (equal), ​Investigation (equal), Methodology (equal)

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Eythimia Varytimiadi

Eythimia Varytimiadi

Department of Cardiology, ATTIKON University Hospital, National and Kapodistrian University of Athens, Athens, Greece

Contribution: Data curation (equal), Formal analysis (equal), ​Investigation (equal), Methodology (equal)

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Maria Kosmidou

Maria Kosmidou

Department of Neurology, University Hospital of Ioannina, University of Ioannina, Ioannina, Greece

Contribution: Data curation (equal), Formal analysis (equal), ​Investigation (equal), Methodology (equal)

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Katerina Naka

Katerina Naka

2nd Department of Cardiology, University Hospital of Ioannina, University of Ioannina, Ioannina, Greece

Contribution: Data curation (equal), Formal analysis (equal), Methodology (equal)

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Lampros K. Michalis

Lampros K. Michalis

2nd Department of Cardiology, University Hospital of Ioannina, University of Ioannina, Ioannina, Greece

Contribution: Project administration (equal), Supervision (equal), Writing - review & editing (equal)

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Georgios Tsivgoulis

Georgios Tsivgoulis

2nd Department of Neurology, ATTIKON University Hospital, National and Kapodistrian University of Athens, Athens, Greece

Contribution: Project administration (lead), Supervision (lead), Writing - review & editing (equal)

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First published: 08 December 2020
Citations: 12
Lampros K. Michalis and Georgios Tsivgoulis share co-senior authorship.

Abstract

Background and purpose

A remarkable decline in admissions for acute stroke and acute coronary syndrome (ACS) has been reported in countries severely hit by the COVID-19 pandemic. However, limited data are available from countries with less COVID-19 burden focusing on concurrent stroke and ACS hospitalisation rates from the same population.

Methods

The study was conducted in three geographically and demographically representative COVID-19 referral university hospitals in Greece. We recorded the rate of stroke and ACS hospital admissions during a 6-week period of the COVID-19 outbreak in 2020 and compared them with the rates of the corresponding period in 2019.

Results

We found a greater relative reduction of stroke admissions (51% [35 vs. 71]; incidence rate ratio [IRR]: 0.49, p = 0.001) compared with ACS admissions (27% [123 vs. 168]; IRR: 0.73, p = 0.009) during the COVID-19 outbreak (p = 0.097). Fewer older (>65 years) patients (stroke: 34.3% vs. 45.1%, odds ratio [OR]: 0.64, p = 0.291; ACS: 39.8% vs. 54.2%, OR: 0.56, p = 0.016) were admitted during the COVID-19 compared with the control period.

Conclusions

Hospitalisation rates both for stroke and ACS were reduced during the COVID-19 outbreak in a country with strict social distancing measures, low COVID-19 incidence and low population mortality. Lack of triggers for stroke and ACS during social distancing/quarantining may explain these observations. However, medical care avoidance attitudes among cerebro/cardiovascular patients should be dissipated amidst the rising second COVID-19 wave.

CONFLICT OF INTEREST

The authors have no conflicts of interest to report.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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