Impact of the COVID-19 Pandemic in the Acute Stroke Admissions and Outcomes in a Philippine Tertiary Hospital

BACKGROUND AND PURPOSE: The COVID-19 pandemic has been continuing its global spread ever since its onset, and efforts to curb the infection in multiple reports have contrasting effects on stroke severity, admissions, and outcomes. In the Philippines, where the COVID-19 pandemic shows no signs of slowing down and has been in the world's longest lockdown, we investigated the effect of the pandemic in the stroke admissions and outcomes in one of the largest tertiary hospitals in the Philippines. METHODS: This is a retrospective, comparative study of all adult stroke patients admitted between pre-COVID-19 (February 2019–January 2020) and COVID-19 periods (February 2020–January 2021). The differences of stroke types, severity, classification, and discharge outcomes between pre-COVID-19 and during COVID-19 were analyzed in the study. RESULTS: There is a decrease in total number of stroke admissions from 597 in the pre-COVID-19 period to 487 during the pandemic. Stroke patients take significantly longer time to seek hospital consultation from the onset of stroke symptoms, and significantly higher proportion of patients have moderate and severe stroke. The discharge outcome showed significantly higher proportions of dependency upon discharge (13%) and higher proportion of death in stroke patients from 7% pre-CO­VID-19 pandemic to 13% during the pandemic. CONCLUSIONS: There was reduction in total stroke admissions, mild and transient stroke during the pandemic. There were a significantly higher proportion of stroke patients having moderate and severe stroke. The discharge outcome of stroke patients is functionally poorer during the pandemic, and more stroke patients have died compared before the COVID-19 pandemic.