Fewer African Americans in South Carolina sought stroke care at pandemic's start

The COVID-19-related hesitancy to seek medical care at a hospital may be disproportionately affecting African American stroke patients, according to new research published today in Stroke.

In the study, "African Americans are Less Likely to Present with Strokes During COVID-19 Pandemic—Observations from the Stroke Belt," neurology specialists in South Carolina analyzed trends in interactive videoconferencing consultation for remote stroke care, also known as telestroke, during the COVID-19 pandemic.

The Medical University of South Carolina in Charleston is the hub for a large, video-based telestroke network serving more than 38 hospitals throughout the state. South Carolina is part of the Stroke Belt—states in the southeastern U.S. where stroke death rates are as much as 34% higher than in other parts of the country.

Researchers compared the electronic health records of more than 5,800 stroke patients who received care through the University's telestroke service before the pandemic (March 2019-February 2020) and during the first two months of the pandemic (March-April 2020). The median number of weekly telestroke consultations dropped from 112 during the 12 months before the pandemic to 77 during the first two months of the pandemic. The analysis also found that African Americans were less likely to present with strokes during the pandemic—dropping from 29% of all patients in the 12 months before the pandemic to 13.9% of the 613 stroke patients during the first two months of the pandemic.

"The lower percentage of African Americans patients who presented with strokes—even those with severe symptoms—during the pandemic is an alarming finding," said Eyad Almallouhi, M.D., lead study author and a neurologist at the Medical University of South Carolina in Charleston. The researchers remarked that African Americans patients have higher risk factors for stroke, higher in-hospital mortality and a greater burden of stroke disability. African Americans patients are also suffering from a higher incidence of COVID-19 infection, as well as an increased mortality rate.

"These results exemplify the crucial need for continued public health education about the importance of immediate stroke care," noted the study authors.

Last month, the American Heart Association launched a new public education and awareness campaign called Don't Die of Doubt to remind all Americans that the hospital remains the safest place to be if they experience symptoms of a heart attack or a stroke.