Fewer strokes diagnosed during first COVID wave

Around 30 percent fewer strokes were diagnosed during the first corona wave than during similar periods in previous years. The number of heart attacks diagnosed remained the same. This is evident from research conducted by the Erasmus MC in the Rotterdam Rijnmond region.

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As people were urged to stay at home as much as possible, this may have led some people to avoid seeking medical care.

Dutch people were less likely to find their way to the family doctor during the first COVID waves. Now it turns out that between March 2020 and May 2020, a lot fewer strokes were diagnosed as well. The number of diagnoses of transient ischemic attacks, also called TIA or ministroke, decreased by 37 percent and the number of strokes by 29 percent, compared to the same period in 2016 – 2019.

The numbers come from research conducted by Erasmus MC, published in the scientific journal Neurology. The researchers used anonymized data from 166,929 patients of general practitioners participating in the Rijnmond Gezond database.

Follow-up research with data from other regions must confirm whether the picture is the same there.


What was striking was that the number of diagnosed cases of heart attack and angina during the COVID waves remained the same as in previous years. ‘We know already that people recognize the symptoms of a heart attack better than those of a stroke. As people were urged to stay at home as much as possible during lockdowns, this may have led some people to avoid seeking medical care despite having symptoms of TIA or stroke’ said researcher Premysl Velek of the Departments of General Medicine and Epidemiology. ‘In contrast, as many people recognize symptoms of heart attack and understand their severity, they sought medical care despite any COVID-19 measures.’

Velek considers it unlikely that there were actually fewer strokes during the corona waves in 2020. ‘The risk factors for stroke and myocardial infarction are almost the same, so we would have seen a decrease in the number of heart attacks as well.’


The number of new cases for stroke or heart attack increased again in the second half of 2020, but the reduction observed during the first wave was not recuperated. It seems, therefore, that a proportion of people with a stroke went untreated. This increases the risk of a second stroke or even death. ‘These missed diagnoses are an unforeseen consequence of the corona measures, the effects of which we are still seeing,’ Velek said.

Family doctor

Earlier this year, other research by Erasmus MC, published in PLOS Medicine, showed that one in five Dutch people did not seek care during the first phase of the pandemic, despite medical complaints. The elderly and young children, in particular, had less contact with their family doctor.

How do I recognize a stroke?

The three most common signs of a stroke are a crooked mouth, slurred speech, or a lame arm. Do you recognize these signs? Then call 112 immediately.

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