TOTAL LOCKDOWN FRANCE CODE

Qualitative variables were presented as frequencies (percentage). In France, national administrative data for stroke have been previously validated. The following variables were extracted: age in 4 classes (<65, 65–79, 80–84, and ≥85 years), sex, length of stay, hospitalization in an intensive stroke unit (SU), neurovascular risk factors (hypertension, diabetes, hypercholesterolemia, obesity, tobacco abuse, atrial fibrillation, and cancer). COVID-19 was identified using specific codes created by the Agence technique de l’information sur l’hospitalisation for this pandemic. We only used the associated diagnoses in the case where COVID was coded as the primary diagnosis to take into account the specific guidelines for coding discharge abstracts for patients with COVID. We used the primary diagnoses for stroke.

TOTAL LOCKDOWN FRANCE CODE

Stroke cases were identified according to the International Classification of Diseases-Tenth Revision Codes based on the discharge diagnosis: the codes for hemorrhagic stroke were I60, I61, and I629, the codes for ischemic stroke were I63 and I64, and the code for TIA was G45. Hospitalizations included possible hospital transfers. Hospitalization data from Januto Jwere extracted from the French National Hospital Discharge database, which collects the medical records of all patients discharged from public and private hospitals. This study was authorized by the French Data Protection Authority on J(Registration number: DR-2020-250 on July 3, 2020). This retrospective study had no impact on patient care, and all data were anonymous. Hospitalization rates for stroke/TIA observed in April 2020 within these 2 regions were compared with the rates from the same period during the 3 previous years (2017–2019). In the 121 hospitals that managed stroke/TIA in this region, 4075 patients were hospitalized for COVID-19 over the same period. The Occitanie region is located in the south-west of France and has 5.9 million inhabitants. In the 111 hospitals that managed stroke/TIA in this region, 15 706 patients were hospitalized for COVID-19 between January and June 2020. The Grand-Est region is located in the north-east of France and has 5.5 million inhabitants. Initially, the French region of Grand-Est was the region most affected by COVID-19 and Occitanie was the region least affected by COVID-19. We retrospectively analyzed all patients admitted to public and private hospitals in Grand-Est and Occitanie for acute stroke subtypes (ischemic and hemorrhagic stroke) and TIA between January and June 2020, including the first peak of the pandemic and the national lockdown in April 2020. These disparities provide the opportunity to describe the hospitalization rates for stroke/TIA and their trends among regions that experienced different rates of COVID-19 infection before, during, and after the lockdown. In France, there were considerable geographic disparities in the spread of COVID-19 during the initial outbreak and the national lockdown of spring 2020 (March 17 to May 11, 2020). 5, 10–13 Moreover, little is known about the changes after the first peak of the epidemic. Some studies suggest that there was an increase during the pandemic, possibly due to the deep hypercoagulable state associated with COVID-19, 8, 9 while a great majority of studies have reported a decrease in rates. There are conflicting findings about hospitalization rates for acute stroke and transient ischemic attack (TIA) in numerous countries during lockdown. In patients with stroke, for instance, delays in stroke care can have devastating effects on functional outcomes, especially with regard to patients with ischemic stroke who are unable to access to rapid revascularization therapy (intravenous thrombolysis and/or mechanical thrombectomy). To date, little is known about the real impact of the coronavirus disease 2019 (COVID-19) pandemic on other medical and surgical emergencies 1–4 although the adverse consequences may be of importance.

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Stroke: Vascular and Interventional Neurology.

Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).

Total lockdown france