TY - JOUR
T1 - Global Impact of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events
AU - Nguyen, Thanh N.
AU - Qureshi, Muhammad M.
AU - Klein, Piers
AU - Yamagami, Hiroshi
AU - Mikulik, Robert
AU - Czlonkowska, Anna
AU - Abdalkader, Mohamad
AU - Sedova, Petra
AU - Sathya, Anvitha
AU - Lo, Hannah C.
AU - Mansour, Ossama Yassin
AU - Vanguru, Husitha Reddy
AU - Lesaine, Emilie
AU - Tsivgoulis, Georgios
AU - Loochtan, Aaron I.
AU - Demeestere, Jelle
AU - Uchino, Ken
AU - Inoa, Violiza
AU - Goyal, Nitin
AU - Charidimou, Andreas
AU - Siegler, James E.
AU - Yaghi, Shadi
AU - Aguiar de Sousa, Diana
AU - Mohammaden, Mahmoud H.
AU - Haussen, Diogo C.
AU - Kristoffersen, Espen Saxhaug
AU - Lereis, Virginia Pujol
AU - Scollo, Sergio Daniel
AU - Campbell, Bruce C.V.
AU - Ma, Alice
AU - Thomas, James Orton
AU - Parsons, Mark W.
AU - Singhal, Shaloo
AU - Slater, Lee Anne
AU - Tomazini Martins, Rodrigo
AU - Enzinger, Chris
AU - Gattringer, Thomas
AU - Rahman, Aminur
AU - Bonnet, Thomas
AU - Ligot, Noemie
AU - De Raedt, Sylvie
AU - Lemmens, Robin
AU - Vanacker, Peter
AU - Vandervorst, Fenne
AU - Christensen, Hanne
AU - Iversen, Helle Klingenberg
AU - Truelsen, Thomas Clement
AU - Wienecke, Troels
AU - Castro, Pedro
AU - Moreira, Tiago T.P.
AU - SVIN COVID-19 Global Stroke Registry
N1 - Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Background and Objectives Declines in stroke admission, IV thrombolysis (IVT), and mechanical thrombectomy volumes were reported during the first wave of the COVID-19 pandemic. There is a paucity of data on the longer-term effect of the pandemic on stroke volumes over the course of a year and through the second wave of the pandemic. We sought to measure the effect of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), IVT, and mechanical thrombectomy over a 1-year period at the onset of the pandemic (March 1, 2020, to February 28, 2021) compared with the immediately preceding year (March 1, 2019, to February 29, 2020). Methods We conducted a longitudinal retrospective study across 6 continents, 56 countries, and 275 stroke centers. We collected volume data for COVID-19 admissions and 4 stroke metrics: ischemic stroke admissions, ICH admissions, IVT treatments, and mechanical thrombectomy procedures. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. Results There were 148,895 stroke admissions in the 1 year immediately before compared with 138,453 admissions during the 1-year pandemic, representing a 7% decline (95% CI [95% CI 7.1-6.9]; p < 0.0001). ICH volumes declined from 29,585 to 28,156 (4.8% [5.1-4.6]; p < 0.0001) and IVT volume from 24,584 to 23,077 (6.1% [6.4-5.8]; p < 0.0001). Larger declines were observed at high-volume compared with low-volume centers (all p < 0.0001). There was no significant change in mechanical thrombectomy volumes (0.7% [0.6-0.9]; p = 0.49). Stroke was diagnosed in 1.3% [1.31-1.38] of 406,792 COVID-19 hospitalizations. SARS-CoV-2 infection was present in 2.9% ([2.82-2.97], 5,656/195,539) of all stroke hospitalizations. Discussion There was a global decline and shift to lower-volume centers of stroke admission volumes, ICH volumes, and IVT volumes during the 1st year of the COVID-19 pandemic compared with the prior year. Mechanical thrombectomy volumes were preserved. These results suggest preservation in the stroke care of higher severity of disease through the first pandemic year.
AB - Background and Objectives Declines in stroke admission, IV thrombolysis (IVT), and mechanical thrombectomy volumes were reported during the first wave of the COVID-19 pandemic. There is a paucity of data on the longer-term effect of the pandemic on stroke volumes over the course of a year and through the second wave of the pandemic. We sought to measure the effect of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), IVT, and mechanical thrombectomy over a 1-year period at the onset of the pandemic (March 1, 2020, to February 28, 2021) compared with the immediately preceding year (March 1, 2019, to February 29, 2020). Methods We conducted a longitudinal retrospective study across 6 continents, 56 countries, and 275 stroke centers. We collected volume data for COVID-19 admissions and 4 stroke metrics: ischemic stroke admissions, ICH admissions, IVT treatments, and mechanical thrombectomy procedures. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. Results There were 148,895 stroke admissions in the 1 year immediately before compared with 138,453 admissions during the 1-year pandemic, representing a 7% decline (95% CI [95% CI 7.1-6.9]; p < 0.0001). ICH volumes declined from 29,585 to 28,156 (4.8% [5.1-4.6]; p < 0.0001) and IVT volume from 24,584 to 23,077 (6.1% [6.4-5.8]; p < 0.0001). Larger declines were observed at high-volume compared with low-volume centers (all p < 0.0001). There was no significant change in mechanical thrombectomy volumes (0.7% [0.6-0.9]; p = 0.49). Stroke was diagnosed in 1.3% [1.31-1.38] of 406,792 COVID-19 hospitalizations. SARS-CoV-2 infection was present in 2.9% ([2.82-2.97], 5,656/195,539) of all stroke hospitalizations. Discussion There was a global decline and shift to lower-volume centers of stroke admission volumes, ICH volumes, and IVT volumes during the 1st year of the COVID-19 pandemic compared with the prior year. Mechanical thrombectomy volumes were preserved. These results suggest preservation in the stroke care of higher severity of disease through the first pandemic year.
U2 - 10.1212/WNL.0000000000201426
DO - 10.1212/WNL.0000000000201426
M3 - Journal article
C2 - 36257718
AN - SCOPUS:85147770827
VL - 100
SP - E408-E421
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 4
ER -