[Clinical and epidemiological indicators of stroke during the COVID-19 pandemic and in the post-COVID period in the Moscow region].

Objective: To analyze the dynamics of clinical and epidemiological indicators of stroke and the features of providing specialized care to patients in the Moscow region in the period 2019-2023.

Material And Methods: Mortality rates, the average annual population, and the number of deaths in one-year age groups were analyzed based on the «Brief Nomenclature of Causes of Death» by ROSSTAT and the database of the Registry Office of the Moscow Region. Depersonalized data on deceased individuals aged 18 years and older were obtained from this database, including codes and names of diseases or conditions specified in Parts I and II of the medical death certificate, age, sex, and place of death for the period 2019-2023. Data on the number and type of reported stroke cases, the number of hospitalized patients, routing, duration of hospitalization, methods of specialized medical care, and hospital mortality were also obtained from the electronic database of the Moscow Regional Medical Information and Analytical Center.

Results: The overall incidence of stroke during the 2019-2023 did not change significantly, averaging 4.3±0.1 cases per 1.000 residents. In 2020, mortality increased by 8.6%, followed by a clear downward trend in this parameter, reaching 15.2% by 2023. The proportion of deaths caused by a combination of stroke and COVID-19 was 7.7%, with the highest figure being 12.2% in 2021. There was a statistically significant increase in the percentage of patients with hemorrhagic stroke (HS) during 2020 and 2021. A sharp (by 30% compared to 2019) drop in the rate of hospitalization of patients with acute cerebrovascular accident within 4.5 hours from the onset of the first symptoms was noted, while the rate of specialized hospitalization in vascular centers increased. After an initial decrease in the number of thrombolytic therapy procedures in 2020, an increase in this indicator to 10% by 2023 was noted. An increase in the proportion of patients who received thromboembolectomy, carotid endarterectomy, and neurosurgical care was also noted.

Conclusion: During the COVID-19 epidemic in the Moscow region, there was a small but statistically significant increase in HS and mortality from stroke. The number of cases of stroke combined with COVID-19 was small (7.7%), and it did not significantly affect morbidity, mortality, or hospital lethality. Despite the end of the epidemic, its impact on the healthcare system can still be seen in the form of fewer vascular centers compared to 2019, and an insufficient number of hospitalized patients during the «therapeutic window».