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Background: With the proposed pathophysiologic mechanism of neurologic injury by SARS CoV-2, the frequency of stroke and henceforth the related hospital admissions were expected to rise. This paper investigated this presumption by comparing the frequency of admissions of stroke cases in Bangladesh before and during the pandemic., Methods: This is a retrospective analysis of stroke admissions in a 100-bed stroke unit at the National Institute of Neurosciences and Hospital (NINS&H) which is considerably a large stroke unit. All the admitted cases from 1 January to 30 June 2020 were considered. Poisson regression models were used to determine whether statistically significant changes in admission rates can be found before and after 25 March since when there is a surge in COVID-19 infections., Results: A total of 1394 stroke patients took admission in the stroke unit during the study period. Half of the patients were older than 60 years, whereas only 2.6% were 30 years old or younger. The male to female ratio is 1.06:1. From January to March 2020, the mean rate of admission was 302.3 cases per month, which dropped to 162.3 cases per month from April to June, with an overall reduction of 46.3% in acute stroke admission per month. In those two periods, reductions in average admission per month for ischemic stroke (IST), intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH) and venous stroke (VS) were 45.5%, 37.2%, 71.4% and 39.0%, respectively. Based on weekly data, results of Poisson regressions confirm that the average number of admissions per week dropped significantly during the last three months of the sample period. Further, in the first three months, a total of 22 cases of hyperacute stroke management were done, whereas, in the last three months, there was an 86.4% reduction in the number of hyperacute stroke patients getting reperfusion treatment. Only 38 patients (2.7%) were later found to be RT-PCR SARS Cov-2 positive based on nasal swab testing., Conclusion: This study revealed a more than fifty percent reduction in acute stroke admission during the COVID-19 pandemic. Whether the reduction is related to the fear of getting infected by COVID-19 from hospitalization or the overall restriction on public movement or stay-home measures remains unknown., Competing Interests: The authors have declared that no competing interests exist.

Background: Different adaptation and changes have been practiced during COVID-19 pandemic. Objective: In this paper we investigated the impact of the COVID-19 pandemic on service delivery in the department of interventional neurology and adaptation of the department to the changed environment. Methodology: This was a retrospective analysis of diagnostic digital subtraction angiography (DSA) procedures done from January 2018 to December 2020 and were analyzed to detect significant breaks in time trend. Results: A total of 358, 426 and 251 patients got admitted for DSA in consecutive three years from 2018 to 2020 respectively. There was a sudden drop in the number of DSA procedures from 30 to 50 patients per month in the pre-COVID era before March 2020 to less than 10 patients per month during the COVID period of March to June 2020. However, the situation gradually improved following the introduction of RT-PCR test for SARS CoV-2 in June 2020. A poison regression showed a significant increase in monthly DSA procedures in the year 2019 compared to the year 2018, but a significant decrease in the pandemic year of 2020. Conclusion: By incorporating COVID-19 testing as a pre-requisite test before DSA procedures, the department of interventional neurology recovered from experiencing a significant drop in the number of performed DSA procedures in the initial periods of the pandemic to reaching a level observed in the pre-COVID era. [ABSTRACT FROM AUTHOR]