{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:22:15Z","timestamp":1787026935856,"version":"build-2736575974"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T00:00:00Z","timestamp":1676505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The COVID-19 pandemic has wrought negative consequences concerning quality of care for stroke patients since its onset. Prospective population-based data about stroke care in the pandemic are limited. This study aims to investigate the impact of COVID-19 pandemic on stroke profile and care in Joinville, Brazil.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective population-based cohort enrolled the first-ever cerebrovascular events in Joinville, Brazil, and a comparative analyzes was conducted between the first 12 months following COVID-19 restrictions (starting March 2020) and the 12 months just before. Patients with transient ischemic attack (TIA) or stroke had their profiles, incidences, subtypes, severity, access to reperfusion therapy, in-hospital stay, complementary investigation, and mortality compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The profiles of TIA\/stroke patients in both periods were similar, with no differences in gender, age, severity, or comorbidities. There was a reduction in incidence of TIA (32.8%;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003). In both periods, intravenous thrombolysis (IV) and mechanical thrombectomy (MT) rates and intervals from door to IV\/MT were similar. Patients with cardioembolic stroke and atrial fibrillation had their in-hospital stay abbreviated. The etiologic investigation was similar before and during the pandemic, but there were increases in cranial tomographies (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.02), transthoracic echocardiograms (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001), chest X-rays (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) and transcranial Doppler ultrasounds (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). The number of cranial magnetic resonance imaging decreased in the pandemic. In-hospital mortality did not change.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The COVID-19 pandemic is associated with a reduction in TIA, without any influence on stroke profile, the quality of stroke care, in-hospital investigation or mortality. Our findings show an effective response by the local stroke care system and offer convincing evidence that interdisciplinary efforts are the ideal approach to avoiding the COVID-19 pandemic's negative effects, even with scarce resources.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2023.1122875","type":"journal-article","created":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T00:54:34Z","timestamp":1676508874000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Stroke profile and care during the COVID-19 pandemic: What changed and what did not? A prospective cohort from Joinville, Brazil"],"prefix":"10.3389","volume":"14","author":[{"given":"Felipe Ibiapina","family":"dos Reis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Silva Correa","family":"de Magalh\u00e3es","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrique","family":"Diegoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre Luiz","family":"Longo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla Heloisa Cabral","family":"Moro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana Antunes","family":"Safanelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian","family":"Nagel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos Christiano","family":"Lange","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viviane Flumignan","family":"Z\u00e9tola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1136\/jnnp-2020-323586","article-title":"Characteristics of ischaemic stroke associated with COVID-19","volume":"91","author":"Beyrouti","year":"2020","journal-title":"J Neurol Neurosurg Psychiatry."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2540","DOI":"10.1161\/STROKEAHA.120.030574","article-title":"Treatment of acute ischemic stroke due to large vessel occlusion with COVID-19: experience from Paris","volume":"51","author":"Escalard","year":"2020","journal-title":"Stroke."},{"key":"B3","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1177\/1747493020937189","article-title":"Cerebral ischemic and hemorrhagic complications of coronavirus disease 2019","volume":"15","author":"Sweid","year":"2020","journal-title":"Int J Stroke."},{"key":"B4","doi-asserted-by":"publisher","first-page":"2656","DOI":"10.1161\/STROKEAHA.120.030397","article-title":"Emergent large vessel occlusion stroke during New York City's COVID-19 outbreak: clinical characteristics and paraclinical findings","volume":"51","author":"Majidi","year":"2020","journal-title":"Stroke."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e60","DOI":"10.1056\/NEJMc2009787","article-title":"Large-vessel stroke as a presenting feature of COVID-19 in the young","volume":"382","author":"Oxley","year":"2020","journal-title":"N Engl J Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1136\/neurintsurg-2020-016220","article-title":"Stroke and mechanical thrombectomy in patients with COVID-19: technical observations and patient characteristics","volume":"12","author":"Wang","year":"2020","journal-title":"J Neurointerv Surg."},{"key":"B7","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/s41256-020-00135-6","article-title":"The novel coronavirus outbreak in Wuhan, China","volume":"5","author":"Zhu","year":"2020","journal-title":"Glob Health Res Policy."},{"key":"B8","unstructured":"WorpB\n            SandsetEC\n            DichgansM\n            CasoV\n          Likely Increase in the Risk of Death or Disability from Stroke During the COVID-19 Pandemic. European Stroke Organisation2020"},{"key":"B9","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1056\/NEJMc2014816","article-title":"Collateral effect of Covid-19 on stroke evaluation in the United States","volume":"383","author":"Kansagra","year":"2020","journal-title":"N Engl J Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1001\/jamaneurol.2020.1127","article-title":"Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China","volume":"77","author":"Mao","year":"2020","journal-title":"JAMA Neurol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"2315","DOI":"10.1161\/STROKEAHA.120.030481","article-title":"Decrease in hospital admissions for transient ischemic attack, mild, and moderate stroke during the COVID-19 era","volume":"51","author":"Diegoli","year":"2020","journal-title":"Stroke."},{"key":"B12","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1136\/svn-2020-000695","article-title":"Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic","volume":"6","author":"Nguyen","year":"2021","journal-title":"Stroke Vasc Neurol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1177\/1747493021991652","article-title":"Global impact of COVID-19 on stroke care","volume":"16","author":"Nogueira","year":"2021","journal-title":"Int J Stroke."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1682","DOI":"10.1161\/STROKEAHA.120.031960","article-title":"Epidemiological surveillance of the impact of the COVID-19 pandemic on stroke care using artificial intelligence","volume":"52","author":"Nogueira","year":"2021","journal-title":"Stroke."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1991","DOI":"10.1161\/STROKEAHA.120.030329","article-title":"Acute stroke care is at risk in the era of COVID-19: experience at a comprehensive stroke center in Barcelona","volume":"51","author":"Rudilosso","year":"2020","journal-title":"Stroke."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1996","DOI":"10.1161\/STROKEAHA.120.030225","article-title":"Impact of the COVID-19 epidemic on stroke care and potential solutions","volume":"51","author":"Zhao","year":"2020","journal-title":"Stroke."},{"key":"B17","doi-asserted-by":"publisher","first-page":"e2824","DOI":"10.1212\/WNL.0000000000011885","article-title":"Global impact of COVID-19 on stroke care and IV thrombolysis","volume":"96","author":"Nogueira","year":"2021","journal-title":"Neurology."},{"key":"B18","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1136\/jnnp.2008.164475","article-title":"Trends in stroke incidence, mortality and case fatality rates in Joinville, Brazil: 1995-2006","volume":"80","author":"Cabral","year":"2009","journal-title":"J Neurol Neurosurg Psychiatry."},{"key":"B19","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1159\/000445060","article-title":"Trends of stroke incidence from 1995 to 2013 in Joinville, Brazil","volume":"46","author":"Cabral","year":"2016","journal-title":"Neuroepidemiology."},{"key":"B20","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1161\/01.STR.27.3.550","article-title":"Comparing stroke incidence worldwide: what makes studies comparable?","volume":"27","author":"Sudlow","year":"1996","journal-title":"Stroke."},{"key":"B21","unstructured":"2006"},{"key":"B22","unstructured":"BrasilI\n          34586252JoinvilleCidades e EstadosInstituto Brasileiro de Geografia e Estat\u00edstica2021"},{"key":"B23","unstructured":"JoinvilleM\n          JoinvilleDados Casos Coronav\u00edrus Munic\u00edpio de JoinvilleSecretaria da Sa\u00fade de Joinville2020"},{"key":"B24","unstructured":"BrasilMinist\u00e9rio da Sa\u00fade do Brasil2020"},{"key":"B25","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1161\/01.STR.24.1.35","article-title":"Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment","volume":"24","author":"Adams","year":"1993","journal-title":"Stroke"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1373","DOI":"10.1136\/jnnp.51.11.1373","article-title":"A prospective study of acute cerebrovascular disease in the community: the Oxfordshire Community Stroke Project 1981\u20131986. 1. Methodology, demography and incident cases of first-ever stroke","volume":"51","author":"Bamford","year":"1988","journal-title":"J Neurol Neurosurg Psychiatry."},{"key":"B27","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1212\/WNL.53.1.126","article-title":"Baseline NIH Stroke Scale score strongly predicts outcome after stroke: a report of the Trial of Org 10172 in acute stroke treatment (TOAST)","volume":"53","author":"Adams","year":"1999","journal-title":"Neurology."},{"key":"B28","doi-asserted-by":"publisher","first-page":"2243","DOI":"10.1161\/01.STR.0000027437.22450.BD","article-title":"Improving the assessment of outcomes in stroke: use of a structured interview to assign grades on the modified Rankin Scale","volume":"33","author":"Wilson","year":"2002","journal-title":"Stroke."},{"key":"B29","doi-asserted-by":"publisher","first-page":"e3373","DOI":"10.1212\/WNL.0000000000010851","article-title":"Stroke risk, phenotypes, and death in COVID-19: systematic review and newly reported cases","volume":"95","author":"Fridman","year":"2020","journal-title":"Neurology."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1826","DOI":"10.1161\/STROKEAHA.121.034301","article-title":"Acute ischemic stroke in patients with COVID-19: an analysis from get with the guidelines-stroke","volume":"52","author":"Srivastava","year":"2021","journal-title":"Stroke."},{"key":"B31","doi-asserted-by":"publisher","first-page":"e2020023440","DOI":"10.1542\/peds.2020-023440","article-title":"Arteritis and large vessel occlusive strokes in children after COVID-19 infection","volume":"147","author":"Appavu","year":"2021","journal-title":"Pediatrics."},{"key":"B32","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1001\/jamaneurol.2021.0504","article-title":"Neurologic involvement in children and adolescents hospitalized in the United States for COVID-19 or multisystem inflammatory syndrome","volume":"78","author":"LaRovere","year":"2021","journal-title":"JAMA Neurol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"E274","DOI":"10.1148\/radiol.2020202197","article-title":"Focal cerebral arteriopathy in a pediatric patient with COVID-19","volume":"297","author":"Mirzaee","year":"2020","journal-title":"Radiology."},{"key":"B34","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/S0140-6736(10)60834-3","article-title":"Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study","volume":"376","author":"O'Donnell","year":"2010","journal-title":"Lancet."},{"key":"B35","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1002\/ana.25967","article-title":"The impact of SARS-CoV-2 on stroke epidemiology and care: a meta-analysis","volume":"89","author":"Katsanos","year":"2021","journal-title":"Ann Neurol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1136\/jnnp-2020-324927","article-title":"Characteristics and outcomes of COVID-19 associated stroke: a UK multicentre case-control study","volume":"92","author":"Perry","year":"2021","journal-title":"J Neurol Neurosurg Psychiatry."},{"key":"B37","doi-asserted-by":"publisher","first-page":"2002","DOI":"10.1161\/STROKEAHA.120.030335","article-title":"SARS-CoV-2 and stroke in a New York healthcare system","volume":"51","author":"Yaghi","year":"2020","journal-title":"Stroke."},{"key":"B38","doi-asserted-by":"publisher","first-page":"2001","DOI":"10.3174\/ajnr.A6793","article-title":"Brain imaging of patients with COVID-19: findings at an academic institution during the height of the outbreak in New York City","volume":"41","author":"Lin","year":"2020","journal-title":"AJNR Am J Neuroradiol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1097\/WCO.0000000000000887","article-title":"The role of telemedicine in acute stroke treatment in times of pandemic","volume":"34","author":"Hubert","year":"2021","journal-title":"Curr Opin Neurol."},{"key":"B40","unstructured":"2020"},{"key":"B41","unstructured":"2020"},{"key":"B42","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1177\/2396987320942622","article-title":"Stroke care in Italy: an overview of strategies to manage acute stroke in COVID-19 time","volume":"5","author":"Zedde","year":"2020","journal-title":"Eur Stroke J."},{"key":"B43","doi-asserted-by":"publisher","first-page":"297","DOI":"10.3390\/neurolint13030030","article-title":"What the aftermath of the global pandemic will mean for neurologists","volume":"13","author":"Rutovic","year":"2021","journal-title":"Neurol Int."},{"key":"B44","unstructured":"2021"},{"key":"B45","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1056\/CAT.22.0283","article-title":"Joinvasc: organizing the full cycle of stroke care with universal coverage","volume":"1","author":"Diegoli","year":"2022","journal-title":"NEJM Catal Innov Care Deliv."},{"key":"B46","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1111\/ijs.12062","article-title":"Past, present, and future of stroke in middle-income countries: the Brazilian experience","volume":"8","author":"Martins","year":"2013","journal-title":"Int J Stroke"},{"key":"B47","doi-asserted-by":"publisher","first-page":"3478","DOI":"10.1111\/ene.14727","article-title":"Cerebral venous thrombosis and severe acute respiratory syndrome coronavirus-2 infection: a systematic review and meta-analysis","volume":"28","author":"Baldini","year":"2021","journal-title":"Eur J Neurol."},{"key":"B48","doi-asserted-by":"publisher","first-page":"104984","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.104984","article-title":"Hemorrhagic stroke and anticoagulation in COVID-19","volume":"29","author":"Dogra","year":"2020","journal-title":"J Stroke Cerebrovasc Dis."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1122875\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T00:54:47Z","timestamp":1676508887000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1122875\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,16]]},"references-count":48,"alternative-id":["10.3389\/fneur.2023.1122875"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2023.1122875","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,16]]},"article-number":"1122875"}}