Introduction Although there is evidence to suggest a high rate of cerebrovascular complications in patients with SARS-CoV-2 infection, anecdotal reports indicate a falling rate of new ischemic stroke diagnoses. We conducted an exploratory single-center analysis to estimate the change in number of new stroke diagnoses in our region, and evaluate the proximate reasons for this change during the COVID-19 pandemic at a tertiary care center in New Jersey. Patients and Methods A Comprehensive Stroke Center prospective cohort was retrospectively analyzed for the number of stroke admissions, demographic features, and short-term outcomes 5 months prior to 3/1/2020 (pre-COVID-19), and in the 6 weeks that followed (COVID-19 period). The primary outcome was the number of new acute stroke diagnoses before and during the COVID-19 period, as well as the potential reasons for a decline in the number of new diagnoses. Results Of the 328 included patients, 53 (16%) presented in the COVID-19 period. There was a mean fall of 38% in new stroke diagnoses (mean 1.13/day [SD 1.07] from 1.82/day [SD 1.38], p<0.01), which was related to a 59% decline in the number of daily transfers from referral centers (p<0.01), 25% fewer telestroke consultations (p=0.08), and 55% fewer patients presenting directly to our institution by private vehicle (p<0.01) and 29% fewer patients through emergency services (p=0.09). There was no significant change in the monthly number of strokes due to large vessel occlusion (LVO), however the proportion of new LVOs nearly doubled in the COVID-19 period (38% vs. 21%, p=0.01). Conclusions The observations at our tertiary care corroborate anecdotal reports that the number of new stroke diagnoses is falling, which seems related to a smaller proportion of patients seeking healthcare services for milder symptoms. These preliminary data warrant validation in larger, multi-center studies.

中文翻译：

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COVID-19 大流行期间综合性中风中心的中风率下降。

简介 尽管有证据表明 SARS-CoV-2 感染患者脑血管并发症发生率较高，但有传闻称新发缺血性中风诊断率有所下降。我们进行了一项探索性单中心分析，以估计我们地区新发中风诊断数量的变化，并评估新泽西州一家三级护理中心在 COVID-19 大流行期间发生这种变化的直接原因。患者和方法 综合卒中中心前瞻性队列回顾性分析了 2020 年 3 月 1 日之前的 5 个月（COVID-19 之前）以及 2020 年 3 月 1 日之前的 6 周内的卒中入院人数、人口特征和短期结果。随后（COVID-19 时期）。主要结果是COVID-19之前和期间新诊断的急性卒中数量，以及新诊断数量下降的潜在原因。结果 在纳入的 328 名患者中，有 53 名 (16%) 是在 COVID-19 期间就诊的。新发卒中诊断平均下降 38%（平均 1.13/天 [SD 1.07]，从 1.82/天 [SD 1.38]，p<0.01），这与每日转诊数量下降 59% 有关。转诊中心 (p<0.01)、远程中风咨询减少 25% (p=0.08)、通过私家车直接到我们机构就诊的患者减少 55% (p<0.01)、通过紧急服务的患者减少 29% (p=0.09) 。由于大血管闭塞 (LVO) 导致的每月中风次数没有显着变化，但新发 LVO 的比例在 COVID-19 期间几乎翻了一番（38% vs. 21%，p=0.01）。结论 我们三级医疗机构的观察结果证实了新发中风诊断数量正在下降的传闻，这似乎与因症状较轻而寻求医疗服务的患者比例较小有关。这些初步数据值得在更大规模的多中心研究中进行验证。