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Is the COVID-19 pandemic magnifying disparities in stroke treatment?
  1. Robert W Regenhardt,
  2. Michael J Young,
  3. Thabele M Leslie-Mazwi
  1. Neurology and Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Robert W Regenhardt, Neurology and Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA; robert.regenhardt{at}

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The coronavirus disease 2019 (COVID-19) pandemic has had widespread effects across healthcare systems worldwide.1–3 Mounting evidence supports a relationship between COVID-19 and both stroke pathophysiology4 5 and stroke systems of care, with decreased stroke presentations and delays in care.6 7 The pandemic’s effects have been felt at the patient level where fears of contagion may foster avoidance of the hospital environment,8 at the provider level where working conditions have been strained, and at the healthcare system level where protean resource limitations have emerged. These challenges may be responsible for magnifying well-described and long-standing disparities in stroke care, including those involving race, ethnicity, sex, socioeconomic status, and disability.9

In their paper entitled “Alarming downtrend in mechanical thrombectomy rates in African American patients during the COVID-19 pandemic: insights from STAR”, Al Kasab et al describe a retrospective study using prospectively collected data from the Stroke Thrombectomy and Aneurysm Registry (11 US centers, 1 German).10 During the COVID-19 pandemic there were significantly fewer black patients treated with thrombectomy than expected based on historical data (24% of 235 patients in February to May 2020 compared with 33% of 1848 patients between January 2017 and …

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  • Contributors All authors have participated in the drafting and editing of this commentary. Each has read and approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

  • Data availability statement Not applicable.

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