Ménard Review Finds COVID-19 Pandemic Disrupted Stroke Care Worldwide
- Stroke care worldwide suffered severe disruptions during the COVID-19 pandemic, with patients facing delayed hospital arrivals, reduced admission rates, and worse clinical outcomes, according to a scoping review...
- The scoping review analyzed 107 studies published between December 2019 and September 2024 to evaluate the pandemic's impact on stroke care across the entire care continuum.
- Throughout the pandemic, many patients delayed seeking medical attention due to fears of contracting COVID-19 in hospital environments and the perception that healthcare systems were overwhelmed.
Stroke care worldwide suffered severe disruptions during the COVID-19 pandemic, with patients facing delayed hospital arrivals, reduced admission rates, and worse clinical outcomes, according to a scoping review published in BMC Health Services Research by Ménard and colleagues.
Mapping the Impact Across 107 Studies
The scoping review analyzed 107 studies published between December 2019 and September 2024 to evaluate the pandemic’s impact on stroke care across the entire care continuum. Researchers screened 1,405 studies before selecting the 107 papers that met eligibility criteria, grouping findings into seven major subthemes covering patient conduct, stroke characteristics, and healthcare delivery. These disruptions exposed critical vulnerabilities in emergency medical responses and highlighted widespread alterations in healthcare utilization, treatment delivery, and patient recovery.
COVID-19 Fears Caused Stroke Admissions to Drop
Throughout the pandemic, many patients delayed seeking medical attention due to fears of contracting COVID-19 in hospital environments and the perception that healthcare systems were overwhelmed. These delays were especially prominent among individuals exhibiting milder stroke symptoms, frequently causing them to arrive outside critical treatment windows. Consequently, multiple studies documented sharp drops in monthly stroke admissions. One analyzed study recorded a 31% decrease in monthly ischaemic stroke admissions, while another documented a 44% decline. Patients who did reach the hospital often presented with significantly more severe strokes driven by delayed presentation, social isolation, and emergency care avoidance.
Systemic Disruptions Increased Stroke Mortality Rates
Hospital systems confronted intense pressure characterized by resource reallocation, workforce shortages, and modified stroke care pathways. The review linked these systemic disruptions to poorer recovery outcomes and elevated mortality rates. One examined analysis reported higher mortality at discharge among patients treated during the pandemic compared with pre-pandemic cohorts, showing mortality rates of 7.7% versus 2.5%, respectively. Disability at discharge also spiked significantly, with one study noting a median modified Rankin Scale score of 4 during the pandemic compared to 2 before it. These functional differences persisted three months post-stroke.
The Promise and Limits of Pandemic Telemedicine
Although the rapid deployment of telemedicine helped sustain continuity of care for younger populations, lower utilization among older adults highlighted persistent inequalities in remote healthcare access. Authors of the scoping review concluded that future emergency preparedness frameworks must prioritize adaptable stroke care systems, equitable telemedicine infrastructure, targeted patient education, and proactive strategies to minimize treatment delays.