The study was conducted among neurologists in 13 major stroke care centres across the country
Stroke care has been affected significantly in India, including Gujarat, because of the COVID-19 outbreak, and made it more challenging, a study covering experts from 13 established stroke centres, including AIIMS Delhi, PGI Chandigarh, and CMC Ludhiana, shows.
The study discussing the challenges of stroke care during COVID-19 outbreak was published in the prestigious Annals of New York Academy of Sciences, US, recently.
The study was conducted among neurologists in 13 major stroke care centres across the country. From Gujarat, NHL Municipal Medical College, Sterling Hospital, Zydus Hospital, and Neuro 1 were a part of the study. Hospitals / institutes from Chandigarh, Bengaluru, Thiruvananthapuram, Pune, Mumbai, and Kolkata were also a part of the study.
The study included neurologists and neuroscientist from Gujarat, Prof Sudhir Shah, Head of Dept, Smt NHL Municipal Medical College and Sterling Hospital, Dr Arvind Sharma, Senior Consultant & Stroke specialist, Zydus Hospitals and Dr Pallab Bhattacharya, Neuroscientist, NIPER-Ahmedabad
“An overall reduction of about 61.22 per cent in reporting of weekly stroke cases has been observed across the country since the lockdown. Intravenous thrombolysis and endovascular procedures have been severely impacted with 64.76 per cent and 67.21 per cent reduction respectively. The drop in cases occurred equally in both COVID-19 designated and non-designated hospitals,” said Prof Shah.
The study also noted similarities in the impact of COVID-19 on stroke care in India and the US.
“The decrease in acute stroke cases presenting to emergency rooms at stroke centres has been estimated at 30-40 per cent in the US, about two-thirds of the reduction seen in India. Similarly, there is 50 per cent reduction in all reperfusion therapies in the US, including thrombolysis and thrombectomies, which is lower than in India,” said Dr Bhattacharya who conceived the study along with Dr Kiran Kalia, Director, NIPER Gandhinagar.
Dr Bhattacharya also said that India has a higher incidence of stroke compared with the US, and the larger magnitude of the decrease in India in reporting of acute cases is troubling.
The study found that public health systems in neither country made proactive efforts to raise awareness to not ignore life-threatening emergencies such as stroke during the COVID-19 pandemic, or to deal with people’s fear of going to hospitals, which it attributes to the fact that public health systems were completely unprepared for handling the pandemic.
“Extreme measures adopted to contain the spread of COVID-19 have resulted in a fall in the number of stroke patients reaching hospitals in India. The lockdown helped to contain virus and break the chain but has also created difficulty in timely consultation with caregivers, leading minor stroke cases to remain undiagnosed,” said Dr Sharma one of the authors of the study.
The study warned that stroke survivors were facing difficulties in receiving follow-up care, which could lead to a surge in new cerebrovascular and cardiovascular events, but noted that the outbreak has spurred developments in the field of telemedicine.
“Various facets of stroke treatment need reorganisation to provide optimised services during such crises. There is a need for public health systems to improve stroke awareness and to implement proper strategies of triage, acute treatment, rehabilitation plans, teleservices, and virtual check-ins. This will help maintain the continuum of care for stroke care and reduce morbidity and mortality,” the study concluded.