The study, published Monday in the Canadian Medical Association Journal, was conducted by a team of eight doctors and other researchers across the province. “One of the things we began to realize in the early months of the pandemic was that there seemed to be a reduction in the number of people with acute strokes,” lead author Dr. Aravind Ganesh, a neurologist at the University of Calgary, said in an interview. Several countries, he said, were beginning to see a trend of fewer people seeking emergency medical care for various medical issues during the pandemic. “The question people started asking was whether the public health restrictions we had implemented as a result of the pandemic could have some unintended consequences of preventing people from going to the hospital for emergencies such as stroke and heart disease,” Ganesh said. “Thus, the condition for this study came from this very legitimate concern on our part.” The researchers looked at data from 19,531 patients in Alberta from January 2016 to February 2020 and another 4,900 patients in the first year of the COVID-19 pandemic. “In the first wave of the Alberta pandemic, we had a significant reduction in the number of people with acute ischemic stroke – that is, strokes due to blood clots in the brain,” Ganesh explained.
Suspected hospital avoidance
“Along with that, we also found that the use of stroke treatments decreased by about the same amount.” The researchers also found that the number of patients with symptoms of stroke did not return to pre-pandemic levels after the first wave in the spring of 2020. “Especially during the second and third waves of our study, when COVID-19 cases increased, we expected to see an increase in stroke presentation instead of a decrease,” the study said. Ganesh said he and other researchers were able to see what happened to these patients by studying how many people died from strokes. “We found that these out-of-hospital deaths resulted in an increase of four of the five pandemic periods,” he said. “We ended up finding some of these missing brains this way.” Similar results were found in hospitals. “During the second wave of the pandemic and the third wave of the pandemic, more people died in hospital with strokes,” he said. The study looked at data at the population level, so it is not clear why people decided not to seek treatment. “Is it that people waited for help until their strokes became more serious?” asked. Ganesh said researchers did not know for sure, but believed that people were trying to avoid hospitals. “We suspect it was hospital avoidance due to the outpatient deaths we found.” He said the results of the investigation were not all bad. “We actually ended up closing the gap later in the pandemic,” Ganesh said. He said public health officials and doctors also worked to remind people to go to the hospital for emergencies. “What we understand is that we really need to think critically about the kind of public health messages we send during a pandemic.”
