Keywords
COVID-19 pandemic
stress
military aggression
ischemic stroke
hemorrhagic stroke
How to Cite
Abstract
In press
Background. Risk factors for stroke are traditionally divided into uncorrected (age, race, gender) and corrected (associated with adherence to a healthy lifestyle, timely treatment of pathology and perception of stress). Stress levels can increase due to extraordinary events of war and pandemics.
Aim. To conduct a comparative analysis of stroke incidence in the population of the Mukachevo District of Zakarpattia Region of Ukraine in the pre-COVID period, during the pandemic, as well as in the post-COVID period and times of russia's military aggression.
Materials and Methods. A retrospective analysis of medical records of inpatients and the register of patients of the municipal non-profit enterprise "St. Martin's Hospital" (Mukachevo Central District Hospital, Ukraine) was carried out. The 2,316 stroke patients included in the study were exposed to the following risk factors: usual, including controlled and uncontrolled (2019, Group I, 466 patients); ordinary and the impact of the COVID-19 pandemic (2020, Group II, 460 patients); ordinary, the impact of the pandemic and war (2023, Group III, 662 patients); ordinary and the impact of war (2024, Group IV, 728 patients). For the epidemiological calculation, Excel 2019 (Microsoft, USA) and SPSS Statistics 26.0 (IBM, USA) were used. The study was carried out as a private initiative of the authors, without additional funding.
Ethics. The study met the international ethical standards of the Helsinki Declaration of the World Medical Association (1964–2024).
Results. The stroke incidence remained stable in 2019 and 2020 (466 and 460 cases) with a predominance of males (54.1 % and 53.5 %) and the dominance of the ischemic type (80.3 % and 83.0 %). A sharp increase in the number of strokes was noted: 1.42 times compared to 2019 and 1.43 times compared to 2020 in 2023; and 1.56 and 1.58 times, respectively, in 2024. In 2023, an equalization of the stroke frequency between women and men was observed (49.7 % vs. 50.3 %). The largest increase was due to ischemic strokes.
Conclusions. The data obtained indicate no impact of the COVID-19 pandemic on the stroke incidence and a pronounced impact of wartime stress. A statistically significant (p<0.01) association between stroke risk and the psychotraumatic factor was demonstrated, confirmed by an increase in incidence in 2023 by 1.42 times compared to 2019 and by 1.43 times compared to 2020, and in 2024 by 1.56 and 1.58 times, respectively. An association between female sex and increased sensitivity to psychotraumatic factors was identified.
Keywords: social medicine, COVID-19 pandemic, stress, military aggression, ischemic stroke, hemorrhagic stroke.
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