Comparison of the influence of the first and the second wave of COVID-19 pandemic on numbers of admitted ischemic stroke patients, on their diagnostics, treatment, and prognosis

Introduction: The COVID-19 pandemic has affected, is affecting, and will affect all our lives. The first wave of the pandemic in the Czech Republic occurred from March to May 2020, did not reduce the number of hospitalized patients with ischemic stroke at the Regional Hospital Liberec, nor did it affect their dia gnostics, treatment, and prognosis in any way. The question was whether the second wave, occurring in the Czech Republic from October to December 2020, which had a stronger outbreak of the pandemic than in the case of the first wave, had already had a negative impact on the numbers and care for patients with ischemic stroke. Methods: We carried out a retrospective comparison of 325 patients admitted to our department with a dia gnosis of ischemic stroke in a 3-month period of the first wave of the COVID-19 pandemic from March to May 2020, in a 3-month period of the second wave of the COVID-19 pandemic from October to December 2020, and in a 3-month reference period to the second wave of the COVID-19 pandemic from October to December 2019. Results: The total number of ischemic stroke patients hospitalized at Liberec Regional Hospital in Liberec was higher during the second wave of the COVID-19 pandemic (10-12/2020) than during the first wave of the COVID-19 pandemic (3-5/2020), but lower than in the reference period 10-12/2019. Regarding all observed parameters characterizing the care for patients with ischemic stroke, four statistically significant differences were found between the compared patient groups - door-to-groin time and door-to-reperfusion time prolongation, increase of the number of patients with wake-up stroke, and worse clinical outcome of patients upon discharge from the intensive care unit. Conclusion: The second wave of the COVID-19 pandemic, like the first one, did not influence the total number of hospitalized patients with ischemic stroke at Liberec Regional Hospital. However, on the contrary to the first wave, it had a negative impact on their dia gnostics, treatment, and short-term prognosis.