Effect of the COVID-19 Pandemic on ICU Ischemic and Hemorrhagic Stroke Outcomes (4551)

• DOI: 10.1212/wnl.96.15_supplement.4551
• Publication Date: 2023-12-07T05:55:31Z
• Authors: Aditya Sharma; Charith Ratnayake; Nicole Paul; Aleksandra Safonova; Valeria Altamirano; Abigail Skeel; Michal Hammond; Ali Scott; Lauren Kaplan; Sherry Chou
• Keywords: Pandemic; 2019-20 coronavirus outbreak; Stroke; Betacoronavirus

Objective: Evaluate impact of COVID-19 pandemic on mortality and care limitations in critically-ill stroke patients. Background: overwhelmed medical systems leading to resource shortages many regions, which may non-COVID This is particular concern severe population where perceived poor prognosis can lead early the self-fulfilling prophecy worse outcomes. Design/Methods: During first 3 months (03/28/30-06/28/20) we prospectively enrolled consecutive adults with acute ischemic (AIS), intracerebral hemorrhage (ICH), subarachnoid (SAH) meeting pre-pandemic criterial for intensive unit (ICU) admission at single comprehensive center, systematically recorded status, pre-existing code disease severity, transition do-notresuscitate (DNR), do-not-intubate (DNI), comfort measures (CMO) status inhospital mortality. Results were compared a 3-months retrospective cohort from prior global (10/1/19-12/31/19). Results: Pandemic (N=196, mean age 63, 48% female, 60% AIS, 26% ICH, 14% SAH, 22% person-under-investigation) (N=199, 46% 58% 16% SAH) similar. Our hospital did not experience during peak pandemic. Compared cohort, had similar severity scores but more (90% vs. 98% full code, p=0.005), frequent DNR (13% 5%, p=0.0025), DNI (10% 3%, p=0.0078), higher in-hospital (21% 9%, p=0.0012). Conclusions: was associated lower incidence patients center that shortages. Further studies are needed determine whether these results due in-person family visit restrictions Multicenter observations hold true centers impacted by