Stroke Care During the COVID-19 Pandemic
Stroke and TIA Care During the COVID-19 Pandemic: Regional Patterns and Epidemiological Determinants
Background: The SARS-CoV-2 pandemic led to substantial changes in the allocation of healthcare resources and affected the behavior of patients experiencing stroke symptoms. Previous studies have mainly focused on the so-called "first wave" of the pandemic during the first half of 2020. During this period, the number of hospital admissions of patients with transient ischemic attacks (TIAs) and minor strokes decreased significantly in many hospitals. This reduction was attributed not only to the reallocation of healthcare resources toward the care of patients with COVID-19, but also to patients' concerns about becoming infected with SARS-CoV-2 during a hospital stay. Since then, the situation has changed, as hospitals have become better prepared to treat patients with COVID-19 and the public has become better informed about the risks of SARS-CoV-2 infection. It is therefore possible that the pattern of acute stroke care during the subsequent wave of COVID-19, which began in autumn 2020, differed from that observed during the first wave.
Aim: The aim of this project is to analyze changes in patterns of acute stroke care across different regions of Europe during the first and subsequent waves of the COVID-19 pandemic and to identify epidemiological determinants associated with changes in stroke care.
Methods: We will collect and analyze data on hospital admissions of patients with acute ischemic stroke, hemorrhagic stroke, and transient ischemic attacks (TIAs) from approximately 40 participating stroke units across Europe for the period from January 1, 2019, to June 30, 2021.
The following parameters will be collected:
Number of hospital admissions per month and mean length of hospital stay (LOS) per month from January 1, 2019, to June 30, 2021, for the following diagnoses:
ischemic stroke hemorrhagic stroke transient ischemic attack Monthly numbers of thrombolysis and thrombectomy procedures during the same period.
Epidemiological parameters: population density, population age, geography of the region, urban/rural region properties, traffic connection to the first European hot spot of Covid-19, number of nursing homes Care characteritics: hospital size, stroke unit capacity.
Statistical analysis: Changes in the number of stroke admissions and length of hospital stay, as well as rates of thrombolysis and thrombectomy, will be analyzed in relation to regional COVID-19 incidence and mortality rates and other epidemiological parameters, including epidemiological connectivity to the first European COVID-19 hotspot.
Expected outcomes: We aim to identify regional patterns of change in acute stroke care during different phases of the COVID-19 pandemic and to determine epidemiological factors associated with these changes.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Locations
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Prague, Czechia
- Recruiting
- Departement of Neurology 1st Medical Faculty and General Teaching Hospital
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Contact:
- Pavel Dušek, MD
- Phone Number: +420 224 965 501
- Email: pavel.dusek@vfn.cz
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Mainz, Germany
- Recruiting
- University Hospital Mainz
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Contact:
- Sergiu Groppa, Professor
- Phone Number: +496131170
- Email: Sergiu.Groppa@uks.eu
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Bergamo, Italy
- Recruiting
- UOC Neurologia, ASST Papa Giovanni XXIII
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Contact:
- Maria Sessa, Professor
- Phone Number: +39035267111
- Email: msessa@asst-pg23.it
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Barcelona, Spain
- Recruiting
- University of Barcelona, Comprehensive Stroke Center, Hospital Clinic
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Contact:
- Ángel Chamorro, Professor
- Phone Number: +34 932 27 54 00
- Email: achamorro@clinic.cat
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
stroke transient ischemic attack
Exclusion Criteria:
traumatic cause of stroke
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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hospital admissions
Time Frame: 2,5 years
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hospital admissions for stroke ot TIA
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2,5 years
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Collaborators and Investigators
Sponsor
Publications and helpful links
General Publications
- Hbid Y, Stanley K, Wolfe CDA, Bhalla A, James M, Douiri A; SSNAP Collaboration. Stroke care in the United Kingdom before, during, and after the COVID-19 lockdowns: A retrospective nationwide cohort study. PLoS One. 2025 Sep 2;20(9):e0330903. doi: 10.1371/journal.pone.0330903. eCollection 2025.
- Dengler J, Abdullah B, Kukolja J, Kuhlen R, Hohenstein S, Dengler NF, Bollmann A, Palm F. Frailty in Stroke Care in Germany Between 2016 and 2022-A Retrospective, Hospital-Based Nationwide Cohort Study. NeuroSci. 2025 Sep 8;6(3):88. doi: 10.3390/neurosci6030088.
- Abe K, Shibata S, Miyawaki A, Kawachi I. Changes in inpatient and outpatient stroke admissions during COVID-19: a difference-in-differences analysis based on claims data from 242 acute care hospitals in Japan. BMJ Public Health. 2025 Sep 29;3(2):e001958. doi: 10.1136/bmjph-2024-001958. eCollection 2025.
- Reddi P, Mehta A, Hardigan T, Shafizadeh M, Kellner CP, Dangayach NS, Fifi JT, Mocco J, Majidi S. Acute Ischemic Stroke and Endovascular Thrombectomy During COVID-19 Pandemic: A Nationwide Analysis. Neurosurg Pract. 2025 May 23;6(2):e00144. doi: 10.1227/neuprac.0000000000000144. eCollection 2025 Jun.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- STROCOV19
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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