Decrease in patients presenting with stroke

Due to the coronavirus (COVID-19), healthcare facilities across the nation are seeing a decline in the number of patients arriving to emergency rooms for treatment of stroke. This is not due to a decline in strokes occurring. Stroke symptoms are generally recognized by a family member or friend before the person suffering a stroke realizes they have symptoms. With the initial stay-at-home orders to decrease the spread of COVID-19, stroke symptoms may have gone unnoticed due to limited face-to-face interactions. Two more reasons identified for a decrease in patients presenting with strokes are: busy emergency rooms and patient’s fear of catching the coronavirus while in the hospital.

A stroke is like a heart attack, but in the brain. Strokes are just as important for seeking emergency treatment. It is crucial that the public is aware of signs and symptoms of a stroke and to seek emergency treatment immediately if these symptoms occur.

Understanding your risk of stroke and modifying these risks are important:

1. Hypertension (Blood pressure more than 120/80)

2. Smoking

3. Overweight

4. Poor Diet & Exercise Levels

5. Diabetes Mellitus (fasting blood sugar more than 100 mg/dL)

6. Hyperlipidemia (fasting cholesterol more than 200 mg/dL)

7. Alcohol Consumption

8. Heart Disease (especially irregular heart rhythm, like Atrial Fibrillation)

Risk factors that cannot be modified:

1. Age (over 55 at greatest risk; young people can also have strokes)

2. Sex (stroke is the leading cause of death in men; 1 in 5 women will have a stroke)

3. Race/Ethnicity (African-Americans have a higher risk of strokes than other ethnicities)

4. Genetics (family history of stroke or heart disease)

If you have a sudden onset of the following symptoms, seek emergency treatment at the nearest emergency room or call 911. Think BE FAST:

B – Balance (difficulty walking, stumbling)

E – Eyes (Blurred vision, double vision, loss of vision)

F – Facial Drooping (one side of face droops when asked to smile)

A – Arm Weakness (numbness, weakness, or inability to move arm)

S – Speech Difficulty (slurred speech, garbled speech, loss of speech)

T – TIME TO CALL 911! (Immediately!)

You may require treatment with a “clot buster” medication, tissue plasminogen activator, or a thrombectomy, which removes the blood clot from an artery in your brain. There is time window for both of these treatments, therefore immediate recognition of symptoms and prompt arrival to an emergency room is detrimental in reducing lifelong disabilities or death from a stroke.

*This article is published based on the professional opinion of G. Nicole Fant and Sheila Moore and is not a reflection of Texas A & M University – Texarkana.*

References:

American Heart Association. (2019). FAQs about brain health. https://www.heart.org/en/health-topics/brain-health/brain-health-resourc...

Aroor, S., Singh, R., and Goldstein, L. B. (2017). BE-FAST (Balance, Eyes, Face, Arm, Speech, Time): Reducing the proportion of strokes missed using the FAST mnemonic. Stroke, 48, 479-481. https://doi.org/10.1161/STROKEAHA.116.015169

Centers for Disease Control and Prevention (CDC). (2020). Men and stroke. https://www.cdc.gov/stroke/men.htm

Centers for Disease Control and Prevention (CDC). (2020). Women and stroke. https://www.cdc.gov/stroke/women.htm Dula, A. D., Brown, G. G., Aggarwal, A., & Clark, A. L. (2020).

Dula, A. D., Brown, G. G., Aggarwal, A., & Clark, A. L. (2020). Decrease in stroke diagnosis during the COVID-19 pandemic: Where did all our stroke patients go?. JMIR Aging, 3, e21608. https://doi.org/10.2196/21608

Montaner, J., Barragan-Prieto, A., Perez-Sanchez, S., Escudero-Martinez, I., Moniche, F., Sanchez-Miura, J. A., Ruiz-Bayo, L., and Gonzalez, A. (2020). Break in the stroke chain of survival due to COVID-19. Stroke, 51, 2307-2314. https://doi.org/10.1161/STROKEAHA.120.030106