• Mor Saban, Anna Reznik, Tal Shachar, Rachel Wilf-Miron, and Rotem Sivan-Hoffmann.
• Gertner institute for epidemiology and health policy research, Ramat Gan, Israel. Electronic address: mors@gertner.health.gov.il.
• J Crit Care. 2021 Apr 1; 62: 230234230-234.

PurposeTo examine the impact of the COVID-19 pandemic on the presentation and care provided to patients with acute ischemic stroke (AIS) at the emergency department (ED).MethodA retrospective-archive study was conducted between January-April 2020, compared with the parallel months in 2017-2019, in a comprehensive stroke center. We compared the time from symptoms onset to ED arrival, the number of neurologic consultations completed in the ED, patients diagnosed with AIS, patients receiving acute treatment and hospital mortality.ResultsDuring January-April 2020, we found an increase in the proportion of stroke patients arriving at the ED within 6 h of symptom onset: 68-100% per month during the study period, compared with 28-42% per month in the previous years. The number of patients admitted to the ED with suspected AIS declined by 41%, compared to the parallel period in 2019. An increase was noted in the number of patients diagnosed with AIS who underwent treatment, with the number of s endovascular thrombectomy increasing throughout the examined year.ConclusionDuring the COVID-19 pandemic, we observed a significant decline in the number of AIS patients admitted to the ED. Paradoxically, we have seen an increase in the proportion of patients who arrived shortly after the onset of symptoms and received timely treatment. Future studies might investigate the medical mechanism and ramifications of this phenomenon.Copyright © 2021 Elsevier Inc. All rights reserved.

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