Background and Objective:
Myocardial infarction and stroke are two highly time-sensitive emergencies, which require standardized guidelines of timed care pathway to reduce treatment times. Covid-19 profoundly modified use and organization of care, as well as its access in a backdrop of pre-existing health disparities in neuro-cardiovascular diseases. Our aim was to evaluate if the first wave of Covid-19 had deteriorated quality of care for socially or clinically vulnerable stroke and myocardial infarction patients.

Methods:
We included myocardial infarction and stroke patients from two French regional cohorts between January 2019 and August 2020. Associations between vulnerabilities (clinical: age over 65 years, neuro-cardiovascular history; socioeconomic: deprivation index) and care management times were analyzed through multivariate linear mixed models, with an interaction on the time period (pre, per, post-wave).

Results:
218 patients were included (6436 strokes, 2782 myocardial infarctions). The first medical contact-to-procedure time was longer for the elderlies (p