Background and purpose. We sought to evaluate the impact of the Covid-19 infection on hospitalization and mortality rates in patients with ischemic stroke admitted during the 2020 pandemic in Italy.
Methods. We analysed a nationwide, comprehensive, and universal administrative database of consecutive patients admitted for ischemic stroke during and after the national lockdown for Covid-19 infection in 2020 and the equivalent periods of the previous 5 years in Italy. The 2020 observed rates of hospitalizations and mortality of stroke patients with and without Covid-19 infection were compared with the expected rates, according to the trend of the previous 5 years.
Results. During the period of observation, 300,890 hospitalizations for ischemic stroke occurred in Italy. In 2020, 41,302 stroke patients (1102 with concomitant Covid-19 infection) were admitted at 771 centers. The rate of admissions for ischemic stroke during the 2020 pandemic was markedly reduced compared to the previous years (percentage change -23.5). Based on the 5-year trend, the 2020 expected rate of 30-day and 1-year mortality was 9.8% and 23.9%, while the observed incidence of death was 12.2% and 26.7%, respectively (both p<0.001). After multiple corrections, the higher rate of mortality was observed among patients admitted for stroke with a concomitant Covid-19 diagnosis.
Conclusions. During the Covid-19 pandemic in 2020 in Italy, the rate of hospitalizations for ischemic stroke was dramatically reduced, while both 30-day and 1-year mortality was increased, especially in those with a Covid-19 diagnosis, compared to the previous 5-year trend.