LAUSR

Abstract On March 11, 2020, the World Health Organization declared the coronavirus disease 2019 (COVID-19) a pandemic, and in the weeks following, public health organizations, medical associations, and governing bodies throughout the world recommended limiting contact with others to “flatten the curve” of COVID-19. Although both ischemic and hemorrhagic strokes have been reported with COVID-19, there has been anecdotal suggestion of an overall decrease in stroke admissions. To date, the effects of any pandemic on telestroke service lines have not been described. The purpose of this cross-sectional analysis of telestroke activations in the 30 days before and after the declaration of the COVID-19 pandemic is to describe the difference in case volumes of telestroke activations, the characteristics of patients, and treatment recommendations between the two time frames. We found a 50% reduction in total telestroke activations between the pre- and post- groups, 142 and 71, respectively. There were no statistically significant differences in age, sex, diagnosis, or regional variations in activation volumes. The percentage of patients in whom we recommended acute stroke treatment with intravenous alteplase, mechanical thrombectomy, or both, decreased from 44% to 33%. The reasons for the significant decrease in telestroke activations and acute stroke treatment recommendations are likely multifactorial, regardless, underscoring the importance of continued public health measures to encourage patients and families to seek emergent medical care at the time of symptom onset.