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in stroke center (Specialized unit for the treatment of stroke) of Cardarelli, In one month, from March 11 to April 11, there were 4 acute brain events (three thrombotic and one hemorrhagic) in Covid positive patients aged between 50 and 60 years, more than 20% compared to 18 in total treated in the same period of time. Similar data was recorded in Salerno. They are not few, but in light of the thromboembolic nature of the disease, Campania has done well compared to other areas of the country.
IN DEEP
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“According to the news that we receive from colleagues in Bergamo and Brescia, the epicenter of the epidemic emergency in Italy – warns Mario Muto, Cardarelli’s head of interventional neuroradiology: even there 75% of acute stroke events were positive with the inability to organize a pathway separation. We organized early and created a path for positive suspects or Covid. In emergency it is not easy to distinguish and, therefore, one must protect oneself independently and consider all people at risk of contagion. It must be said that in Campania the phenomenon was much more contained, but we are concerned that even weeks after the epidemic peak we could register an increase in cases. We know from current international literature, concludes Muto, that Sars Cov 2 certainly causes inflammatory immune reactions with the development of vasculitis which may be related to an increase in the secondary incidence of cerebral and peripheral thrombosis even after some time after healing. “It is not a coincidence that a similar alarm came from a Manhattan hospital, where in In the past three weeks, cases of young people or middle-aged people who died of stroke and coronavirus positive but who had not even realized they were sick have doubled.
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The one with the silent Covid cases with nonspecific symptoms (neurological but also of a different nature) is a serious public health problem. Therefore, Cardarelli has provided separate routes for suspected or Covid patients who are positive for the treatment of stroke and ischemia and, in view of the openness to scheduled admissions and outpatient activities, screening tests are provided for all inpatients. and the swab in doubtful cases. “There are also separate routes, between Covid and non-Covid, for each time-dependent specialty (stroke, heart attack and trauma) and for major diseases – warns the manager Giuseppe Longo – and staff and patients should always wear protective devices. “However, it is difficult to proceed with caution in urgent cases when arriving at the emergency room. A week ago, a patient with an acute abdomen reported abdominal colic and abdominal pain that it had lasted a month without any other sign as the only symptom.No cough, no wheezing, no fever, but on whole-body CT, performed to verify the cause of his ailments, an outbreak of interstitial pneumonia emerged, which was later confirmed as a covid buffer. For this reason, in addition to the rapid immunoglobulin test, each patient will be treated as a Covid suspect and started on an already defined high isolation route. If swab positivity is confirmed, hospitalization and Medical and surgical treatment will be carried out in Hall M dedicated to Covid, otherwise it will be used for normal hospital stays.
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Finally, to testify that fear of the virus played a deterrent role in access to emergency rooms, even in severe cases from March 11 to April 11, however, there was an 18% drop in access, in compared to 2019, that’s why Ischemic stroke and 40% formyocardial infarction while there is a recovery after Easter. The reasons? They may be different and have also been analyzed at the national level. On the one hand, the fear of contagion but also a less stressful lifestyle. And not infrequently, heart attack patients died before reaching the hospital.
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