Abstract Number: Esoc2026a1640 the Impact of the Covid-19 Pandemic on the Management of Stroke at Ahepa University General Hospital in Greece: Hospitalization Metrics and Healtcare-Associated Infections

Abstract Background and aims Stroke represents the second leading cause of death worldwide. The COVID-19 pandemic disrupted healthcare systems, affecting stroke hospitalization, treatments and healthcare-associated infections. The aim of the study was to assess these effects on stroke patients at AHEPA University General Hospital in Greece. Methods A retrospective study, comparing two periods: the pre-COVID-19 period (01/01/2019-10/03/2020) and the COVID-19 period (11/03/2020-31/12/2021). A total of 322 patients (155 and 167 respectively) with acute stroke were included. Results Hospital admissions declined 38% in 2020 (85 vs. 137), with 55.5% reduction in Q4, partially recovering to 100 in 2021. Mean patient age decreased significantly (66.2 vs. 63.4 years, p=0.038). Stroke subtype distribution shifted (p=0.049): increased ischemic strokes (75.4% vs. 72.3%) and TIAs (10.2% vs. 4.5%), decreased intracerebral hemorrhages (13.2% vs. 22.6%). Median length of stay, stroke severity, and ICU admissions remained unchanged. Acute-phase therapies were maintained, though with decreased use of thrombolysis (8.7% vs. 16.1%) and an increase in mechanical thrombectomy (2.4% vs. 1.8%) and combined therapy (4.0% vs. 0.9%). Lipid-lowering therapies increased significantly (73.1% vs. 60.0%, p=0.013). Overall healthcare-associated infection rates were unchanged (32.9% vs. 34.2%; p=0.811), but specific patterns shifted: urinary tract infections increased (15.0% vs. 2.6%, p0.001), fevers of unknown origin decreased (2.4% vs. 11.6%, p=0.001) and respiratory complications decreased (4.2% vs. 10.3%, p=0.033). Conclusions The COVID-19 pandemic significantly affected stroke management, causing reduced admissions while preserving care quality. Stricter protocols improved specific metrics and reduced hospital-acquired infections, demonstrating healthcare system resilience and the importance of adapting management strategies during health crises. Conflict of interest Dimitrios Digkas: nothing to disclose