The impact of the COVID-19 pandemic on critically ill patients with acute stroke and diabetic ketoacidosis
DOI:
https://doi.org/10.15584/ejcem.2022.2.2Keywords:
diabetic ketoacidosis, strokes, pandemicsAbstract
Introduction and aim. This study aimed to compare the hospitalization rate, mortality rate and morbidity status of patients hospitalized with stroke and diabetic ketoacidosis (DKA) before and during the COVID-19 pandemic.
Material and methods. The data of 2522 patients who applied to the emergency department (ED) before and during the pandemic were evaluated. A Poisson regression analysis was used to examine the number of presentations between two different periods.
Results. Stroke cases during the pandemic era were compared to those during the pre-pandemic period, and it was shown that the mortality rate for stroke patients during the pandemic period was much higher. Treatment-related ED presentations decreased significantly during the pandemic period, particularly among patients aged 75–84 years. Rates of ED presentation decreased by 84 percent (IRR: 0.14, 95 percent CI: 0.03-0.59) in those with DKA and by 37 percent (IRR: 0.67, 95 percent CI: 0.53- 0.75) in those with stroke during the pandemic period.
Conclusion. Conclusion: Stroke and DKA admissions decreased during the pandemic, but the rate of stroke mortality increased statistically 3.375 times. Getting emergency medical care increases their chances of survival. Even in a COVID-19 outbreak, treatment is critical.
Downloads
References
Quah LJJ, Tan BKK, Fua TP, et al. Reorganising the emergency department to manage the COVID-19 outbreak. Int J Emerg Med. 2020;13(1):32.
Perlini S, Canevari F, Cortesi S, et al. Emergency Department and Out- of Hospital Emergency System (112-AREU 118) integrated response to Coronavirus Disease 2019 in a Northern Italy centre. Intern Emerg Med. 2020;15:825-833.
Ak R, Kurt E, Bahadirli S. Comparison of 2 Risk Prediction Models Specific for COVID-19: The Brescia-COVID Respiratory Severity Scale Versus the Quick COVID-19 Severity Index. Disaster Med Public Health Prep. 2021;15(4):e46-e50.
Hartnett KP, Kite-Powell A, DeVies J, et al. Impact of the COVID-19 Pandemic on Emergency Department Visits - United States, January 1, 2019-May 30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(23):699-704.
Wong LE, Hawkins JE, Langness S, et al. Where are all the patients? Addressing COVID-19 fear to encourage sick patients to seek emergency care. NEJM Catalyst. 2020. doi: 10.1056/CAT.20.0193
Brick A, Walsh B, Keegan C, Lyons S. COVID-19 and emergency department attendances in Irish public hospitals. ESRI Series QEC Special Article Dublin. 2020. doi: 10.26504/qec2020may_SA_lyons
Timeline of the COVID-19 pandemic in Turkey. https://en.wikipedia.org. Accessed 3, August 2020.
Çıkrıkçı Işık G, Çevik Y. Impact of COVID-19 pandemic on visits of an urban emergency department. Am J Emerg Med. 2021;42:78-82.
Garcia S, Albaghdadi MS, Meraj PM, et al. Reduction in ST-Segment Elevation Cardiac Catheterization Laboratory Activations in the United States During COVID-19 Pandemic. J Am Coll Cardiol. 2020;75(22):2871-2872.
Gogia S, Newton-Dame R, Boudourakis L, et al. COVID-19 X-curves: illness hidden, illness deferred. NEJM Catalyst. 2020. doi: 10.1056/CAT.20.0231
Baldi E, Sechi GM, Mare C, et al. Out-of-Hospital Cardiac Arrest during the Covid-19 Outbreak in Italy. N Engl J Med. 2020;383(5):496-498.
Kansagra AP, Goyal MS, Hamilton S, Albers GW. Collateral Effect of Covid-19 on Stroke Evaluation in the United States. N Engl J Med. 2020;383(4):400-401.
Zhao J, Li H, Kung D, Fisher M, Shen Y, Liu R. Impact of the COVID-19 Epidemic on Stroke Care and Potential Solutions. Stroke. 2020;51(7):1996-2001.
Bullrich M, Fridman S, Mandzia JL, et al. COVID-19: Stroke Admissions, Emergency Department Visits, and Prevention Clinic Referrals. Can J Neurol Sci. 2020;47(5):693-696.
Pines JM, Zocchi MS, Black BS, et al. The effect of the COVID-19 pandemic on emergency department visits for serious cardiovascular conditions. Am J Emerg Med. 2021;47:42-51.
Benoit SR, Hora I, Pasquel FJ, Gregg EW, Albright AL, Imperatore G. Trends in Emergency Department Visits and Inpatient Admissions for Hyperglycemic Crises in Adults With Diabetes in the U.S., 2006-2015. Diabetes Care. 2020;43(5):1057-1064.
Lange SJ, Ritchey MD, Goodman AB, et al. Potential indirect effects of the COVID-19 pandemic on use of emergency departments for acute life-threatening conditions - United States, January-May 2020. Am J Transplant. 2020;20(9):2612-2617.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 European Journal of Clinical and Experimental Medicine
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our open access policy is in accordance with the Budapest Open Access Initiative (BOAI) definition: this means that articles have free availability on the public Internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from having access to the Internet itself.
All articles are published with free open access under the CC-BY Creative Commons attribution license (the current version is CC-BY, version 4.0). If you submit your paper for publication by the Eur J Clin Exp Med, you agree to have the CC-BY license applied to your work. Under this Open Access license, you, as the author, agree that anyone may download and read the paper for free. In addition, the article may be reused and quoted provided that the original published version is cited. This facilitates freedom in re-use and also ensures that Eur J Clin Exp Med content can be mined without barriers for the research needs.
