Stroke and Covid-19: dramatic drop in patients in the emergency room in case of symptoms act early to avoid permanent damage

Professor's appeal on World Stroke Day 2020 Vincenzo Di Lazzaro, director of Neurology at the Campus Bio-Medico University Hospital, to resort to timely treatment: "The infection causes inflammation and can cause ischemia"

Rome, 26 October 2020 - The Coronavirus pandemic has had a significant impact on all pathologies and in particular the so-called "time-dependent" ones such as ictus and myocardial infarction, in which time is the difference between life and death. For fear of contracting COVID-19, many of the patients affected by these pathologies did not go to the emergency room in a timely mannerthus putting your life at risk in many cases. According to data released by SIEMS – the Italian Health Emergency Society – for example, in the city of Rome alone in the period March-April 2020 there were 305 rescue interventions for stroke, against 358 of the previous year.

“In stroke, the time interval from the onset of symptoms within which it is possible to carry out effective therapeutic interventions, the administration of drugs or the execution of procedures to restore the blood supply in the ischemic areas is very limited, for where if patients arrive late in the emergency department, it can lead to disastrous consequences – says the Professor Vincenzo Di Lazzaro, director of the UOC Neurology of Campus Bio-Medico University Hospital. In general, stroke is less alarming than other pathologies because it does not cause pain, therefore the patient very often does not turn promptly to the emergency network. If he can't move his arm, he may think it's caused by trivial causes, such as having slept in the wrong position during the night and feeling blocked, but in the case of cerebral ischemia there is no time to lose as the time to saving the brain is very limited".

Timely access to the territorial emergency network, in an emergency room such as the one recently launched at the Campus Bio-Medico University Hospital, becomes essential to successfully combat pathologies with a high social impact such as stroke.

Stroke must be recognized by the presenting symptoms which in English are described by the acronym FAST - Face, Arm, Speech, Time – or if a sudden appears mouth deviation, The weakness of a limb, if you have difficulty speaking or to understand what is said, action must be taken quickly in a short time to avoid irreversible brain damage. 

According l 'Stroke Observatory Italy (data from December 2018), this disease represents the first cause of disability in industrialized countries, the second of dementia and the third of mortality. In our country they are registered at least 100 new hospitalizations a year due to stroke, approx one third of those affected do not survive a year from the event, while another third survive with significant disability.

The annual incidence of stroke in Italy is 13 cases per 1.000 inhabitants between 65 and 84 years old. The prevalence in Italy reaches 7,4% in men and 5,9% in women. Currently nearly one million people live with the disabling consequences of a stroke. The disease has a direct cost for the National Health Service of about 16 billion euros a year, to which must be added about 5 billion euros in terms of indirect costs, calculated mainly as lost productivity and assistance costs for chronicity management.

For this reason, in the presence of clear symptoms, it is absolutely necessary to go to the emergency room promptly. “There is a well-defined network, which recently also included the Campus Bio-Medico University Hospital of Rome, with different levels of care in the area. The emergency system is able to transport the patient to the right centre, which is not necessarily the one close to home, but the one specialized in the treatment of cerebrovascular pathologies". continues the Professor Vincenzo Di Lazzaro. These are those centers that can count on the collaboration of various specialists, able to deal with the pathology from several points of view and to avoid even serious consequences for the patient.

Regarding the risk of contracting the COVID infection, it must be borne in mind that "emergency rooms have adapted to be able to manage patients with suspicious symptoms within different pathways compared to others who are taken care of within a traditional treatment pathway", concludes the professor Di Lazzaro.