Patients with stroke younger, present with more severe symptoms since COVID-19

Key takeaways:

• Patients were hospitalized at a younger age in post-COVID-19 groups vs. a pre-pandemic group.
• Pandemic-induced physical and mental stress may have impacted average age of stroke onset, researchers said.

ORLANDO, Fla. — The COVID-19 pandemic likely altered stroke patient characteristics, as those admitted to the hospital were younger and had more severe symptoms over a 2-year post-pandemic interval, according to a poster.

“I had the same thoughts (as other researchers) about whether or not hospital protocols (during the pandemic) impacted stroke outcomes, but that’s why we looked at a second group 2 years after COVID-19,” Alaina Moore, BS, a medical student within the Augusta University/University of Georgia Medical Partnership, said during her presentation at the American Neurological Association annual meeting.

Moore and colleagues evaluated how COVID-19 impacted symptom severity in patients with stroke and their ability to recover, once hospitalized, in both the short and long term.

Their retrospective analysis included a chart review of 404 individuals admitted to Piedmont Athens Regional Hospital in Georgia for ischemic stroke between December 2018 and December 2022.

Patients were subdivided into three groups based on time of admission: pre-COVID-19 group (n = 141; December 2018 to March 11, 2020); post-COVID-19 group 1 (n = 82; March 12, 2020, to March 12, 2021); post-COVID-19 group 2 (n = 181; March 13, 2021, to Dec. 31, 2022).

The researchers analyzed variables such as length of hospital stay, NIH Stroke Scale (NIHSS) score upon admission, patient age and sex, door to CT time and last known time of wellness prior to admission.

According to the results, the length of hospital stay varied significantly across groups and admission timelines, with both post-pandemic groups recording longer stays compared with the pre-pandemic cohort.

The researchers also found that patient age was younger in both post-pandemic groups compared with the pre-pandemic group. Women were more likely than men to present with stroke at older ages across all three groups.

Overall, women were admitted with higher NIHSS scores than men. However, the scores were similar among men and women in the first year post-COVID-19 and significantly higher than men in the second post-COVID-19 year.

Moore and colleagues hypothesized that external factors such as pandemic-induced physical and mental stress may have an impact on the average age of stroke onset. They additionally theorized that men with milder stroke symptoms may have avoided treatment post-pandemic and that higher NIHSS scores in women upon admission may be correlated with older age of stroke incidence.

“We saw the average length of hospital stay increased,” Moore said. “People are staying in hospitals longer and because of the severity of their stroke requires them to be.”