JMIR Publications

ABSTRACT

Despite the evidence to suggest a high rate of cerebrovascular complications in patients with SARS-CoV-2, reports indicate a falling rate of new ischemic stroke diagnoses. An observed decrease in emergency department visits should come as no shock during times of major crises, as patients prioritize avoiding exposure to SARS-CoV-2 against the acute situation that they may perceive as mild symptoms of a headache, lethargy, difficulty speaking, and numbness. In the central and south Texas regions where we practice, we suspect that patient admission, treatment and discharge volumes for acute stroke treatment have decreased significantly since COVID-19 related shelter-at-home orders were issued. Symptoms of stroke are frequently noticed by another family member, friend, or community member before they are recognized in the patients themselves, and perhaps these symptoms are going unnoticed due to limited face-to-face encounters. This emphasizes the importance of patient education on stroke warning signs and symptoms during the current times of isolation and social-distancing. The central Texas population, already saddled with above-average rates of cardiovascular and cerebrovascular disease, has a higher stroke mortality rate compared to Texas and U.S. averages. But the number of patients presenting to emergency departments with acute ischemic stroke diagnoses are lower than average. To put it simply: where did all our stroke patients go?