Impact of COVID-19 pandemic on stroke rate, risk factors, clinical presentation, and outcome, in Hadramout, Republic of Yemen

Rasheed Mohammed Bamekhlah¹, Samira Awad Banser², Saeed Salim Binnoob³, Nasser Mansoor Habtor³, Saeed Abobaker Othman³, Fatima Jumaan Bin Neser³

Keywords: Cerebrovascular accident, COVID-19, Hadramout, Stroke, Yemen

DOI: 10.32677/yjm.v2i1.3839

DOI URL: https://doi.org/10.32677/yjm.v2i1.3839

Publish Date: 10-05-2023

Pages: 25 - 29

Views: 2

Downloads: 4

Author Affiliation:

¹Professor of Internal Medicine, Senior Consultant, Department of Medicine, College of Medicine and Health Sciences (HUCOM), Hadramout University,

²Medical Specialist,

³Resident, Department of Medicine, Ibn-Seena Teaching Hospital, Mukalla, Hadramout, Yemen

Abstract

Background and Objective: The COVID-19 pandemic affected medical care systems including stroke care, globally. In this study, we investigated the impact of the COVID-19 outbreak on stroke care in Hadramout, in terms of rate of admission, access to care, risk factors, clinical presentation, and outcome. Methods: A hospital-based cross-sectional study comparing all stroke patients admitted to Ibn-seena University Hospital (ISTH), Mukalla, Hadramout, during two periods, May 1 to October 31, 2020, during the pandemic of COVID-19 (COVID-19 group), and from May 1 to October 31, 2019 (pre-COVID-19 group). Data collected from patients' medical record files into a master sheet, and were processed by the Statistical Package for Social Sciences (SPSS) software. Results: There were 117 stroke patients  admitted in COVID-19 pandemic in 2020, and 213 patients admitted in the same period in 2019. Stroke admission declined by 45.1% (Odds Ratio(OR)=0.30, 95% confidence interval(95% CI): 0.22-0.42, P<0.0001). with no age and sex differences. Hypertension and diabetes mellitus were more frequent in COVID-19 group than the pre-COVID-19 group (OR=1.74, 95% CI: 1.08-2.80, P=0.02) and (OR=1.81, 95% CI: 1.14-2,88, P=0.01] respectively. No significant difference in other risk factors was found. Patients in COVID-19 group arrived the hospital more late than the patients in pre-COVID-19 group (OR=2.63, 95% CI: 1.64-4.21, P<0.0001). Dysphasia and altered consciousness including coma were more common in COVID-19 group compared with pre-COVID-19 group (OR=4.5, 95% CI: 2.18-9.08, P<0.0001) and (OR=3.2, 95% CI: 2.00-5.12, P<0.0001) respectively. Hospital stay was greatly reduced among COVID-19 group as compared with pre-COVID-19 group (02.9±0.31 days vs. 8.6±0.92 days, P<0.0001) Mortality rate was  higher among COVID-19 group than the pre-COVID-19 group (41.9% vs. 27.2%, P=007).  Conclusion: The number of stroke patients admitted during the COVID-19 pandemic decreased, they arrived late and spent shorter hospital stays while having higher rates of hypertension, diabetes, and impaired consciousness with a high mortality rate.