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. 2020 Sep 15:416:117044.
doi: 10.1016/j.jns.2020.117044. Epub 2020 Jul 16.

COVID-19 and stroke: Experience in a Ghanaian healthcare system

Fred S Sarfo  1 , Naa Oboshie Mensah  2 , Francis Agyapong Opoku  2 , Nathaniel Adusei-Mensah  2 , Michael Ampofo  2 , Bruce Ovbiagele  3
Affiliations

COVID-19 and stroke: Experience in a Ghanaian healthcare system

Fred S Sarfo et al. J Neurol Sci. .

Abstract

Background: The novel coronavirus disease 19 (COVID-19) causes multi-system disease including possibly heightened stroke risk. Data from high-income countries (HIC) suggest disruptions to care delivery with reduced stroke admissions and administration of acute stroke reperfusion therapies. We are unaware of any published data on the impact of the COVID-19 pandemic on stroke admissions and outcomes in sub-Saharan Africa.

Purpose: To compare rates of stroke admissions and case fatality between corresponding periods in 2020 and 2019, within a hospital system in Ghana, to assess the potential impact of the COVID-19 pandemic.

Methods: We compared monthly stroke admissions and mortality rates between January to June 2020 vs. January to June 2019 at the Komfo Anokye Teaching Hospital, a tertiary medical center in Ghana. Predictors of in-patient mortality were assessed using a multivariate logistic regression model.

Results: Stroke admissions were higher in January to June 2020 vs. January to June 2019 (431 vs. 401), an increase of +7.5% (95% CI: 5.1-10.5%). There was also a rise in recurrent stroke admissions in 2020 vs. 2019 (19.0% vs. 10.9%, p = .0026). Stroke case fatality trended higher in 2020 vs. 2019 (29.3% vs. 24.2%, p = .095) with an adjusted odds ratio of 1.22 (95% CI: 0.89-1.68).

Conclusion: While an influence of secular trends cannot be excluded, the COVID-19 outbreak coincided with a comparatively significant rise in initial and recurrent stroke admissions at this Ghanaian tertiary hospital. Continued surveillance at this hospital, as well as assessment of this issue at other sites in Africa is warranted.

Keywords: Africa; COVID-19; Mortality; Recurrence; Stroke admissions.

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Conflict of interest statement

None to declare by all authors.

Figures

Fig. 1
Fig. 1
Trends in stroke admission between January and June 2019 and 2020 in Kumasi, Ghana.
Fig. 2
Fig. 2
Monthly trends in admissions by stroke types between January and June 2019 and 2020 in Kumasi, Ghana.
Fig. 3
Fig. 3
Monthly trends in stroke mortality between January and June 2019 and 2020 in Kumasi, Ghana.
See this image and copyright information in PMC

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References

    1. World Health Organization Coronavirus (COVID-2019) situation reports. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situatio... Accessed July 8, 2020.
    1. Zhang Y., Xiao M., Zhang S. Coagulopathy and antiphospholipid antibodies in patients with COVID-19. N. Engl. J. Med. 2020;382(17) - PMC - PubMed
    1. Klok F.A., Kruip M.J.H.A., van der Meer N.J.M. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020;191(191):145–147. - PMC - PubMed
    1. Helms J., Tacquard C., Severac F. Clinical Research in Intensive Care and Sepsis Trial Group for Global Evaluation and Research in Sepsis. High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study. Intensive Care Med. 2020;46(6):1089–1098. - PMC - PubMed
    1. Oxley T.J., Mocco J., Majidi S. Large-vessel stroke as a presenting feature of COVID-19 in the young. N Engl J Med. 2020;382(20):e60. - PMC - PubMed
-