A1 Refereed original research article in a scientific journal
Global Impact of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events: A 1-Year Follow-up
Authors: Nguyen Thanh N., Qureshi Muhammad M., Klein Piers, Yamagami Hiroshi, Mikulik Robert, Czlonkowska Anna, Abdalkader Mohamad, Sedova Petra, Sathya Anvitha, Lo Hannah C., Mansour Ossama Yassin, Vanguru Husitha Reddy, Lesaine Emilie, Tsivgoulis Georgios, Loochtan Aaron I., Demeestere Jelle, Uchino Ken, Inoa Violiza, Goyal Nitin, Charidimou Andreas, Siegler James E., Yaghi Shadi, Aguiar de Sousa Diana, Mohammaden Mahmoud H., Haussen Diogo C., Kristoffersen Espen Saxhaug, Lereis Virginia Pujol, Scollo Sergio Daniel, Campbell Bruce C.V., Ma Alice, Thomas James Orton, Parsons Mark W., Singhal Shaloo, Slater Lee-Anne, Tomazini Martins Rodrigo, Enzinger Chris, Gattringer Thomas, Rahman Aminur, Bonnet Thomas, Ligot Noemie, De Raedt Sylvie, Lemmens Robin, Vanacker Peter, Vandervorst Fenne, Conforto Adriana Bastos, Hidalgo Raquel C.T., de Oliveira Neves Luciana, Martins Rodrigo Targa, Cuervo Daissy Liliana Mora, Rebello Leticia C., Santiago Igor Bessa, da Silva Isabelle Lameirinhas, Sakelarova Teodora, Kalpachki Rosen, Alexiev Filip, Catanese Luciana, Cora Elena Adela, Goyal Mayank, Hill Michael D., Kelly Michael E., Khosravani Houman, Lavoie Pascale, Peeling Lissa, Pikula Aleksandra, Rivera Rodrigo, Chen Hui-Sheng, Chen Yimin, Huo Xiaochuan, Miao Zhongrong, Yang Shuiquan, Bedekovic Marina Roje, Bralic Marina, Budincevic Hrvoje, Corredor-Quintero Angel Basilio, Lara-Sarabia Osvaldo E., Cabal Martin, Tenora Dusan, Fibrich Petr, Herzig Roman, Hlaváčová Helena, Hrabanovska Emanuela, Hlinovsky David, Jurak Lubomir, Kadlcikova Jana, Karpowicz Igor, Klecka Lukas, Kovar Martin, Lauer David, Neumann Jiri, Palouskova Hana, Reiser Martin, Rekova Petra, Rohan Vladimir, Skoda Ondrej, Škorňa Miroslav, Sobotková Lenka, Sramek Martin, Zakova Lenka, Christensen Hanne, Drenck Nicolas, Iversen Helle Klingenberg, Truelsen Thomas Clement, Wienecke Troels, Sobh Khalid, Ylikotila Pauli, Alpay Kemal, Strbian Daniel, Bernady Patricia, Casenave Philippe, Dan Maria, Faucheux Jean-Marc, Gentric Jean-Christophe, Magro Elsa, Sabben Candice, Reiner Peggy, Rouanet Francois, Bohmann Ferdinand O., Boskamp Stefan, Mbroh Joshua, Nagel Simon, Nolte Christian H., Ringleb Peter A., Rosenkranz Michael, Poli Sven, Thomalla Götz, Karapanayiotides Theodoros, Koutroulou Ioanna, Kargiotis Odysseas, Palaiodimou Lina, Guerra Jose Dominguo Barrientos, Huded Vikram, Menon Bindu, Nagendra Shashank, Prajapati Chintan, Sylaja P.N., Pramana Nyoman Angga Krishna, Sani Achmad Firdaus, Ghoreishi Abdoreza, Farhoudi Mehdi, Hokmabadi Elyar Sadeghi, Raya Tariq Abu, Kalmanovich Shani Avnery, Ronen Levite, Sabetay Sergiu Ionut, Acampa Maurizio, Adami Alessandro, Castellan Lucio, Longoni Marco, Ornello Raffaele, Renieri Leonardo, Bigliani Claudia Rolla, Romoli Michele, Sacco Simona, Salmaggi Andrea, Sangalli Davide, Zini Andrea, Doijiri Ryosuke, Fukuda Hiroki, Fujinaka Toshiyuki, Fujita Kyohei, Imamura Hirotoshi, Sakai Nobuyuki, Kanamaru Takuya, Kimura Naoto, Kono Ryuhei, Miyake Kosuke, Sakaguchi Manabu, Sakai Kenichiro, Sonoda Kazutaka, Todo Kenichi, Miyashita Fumio, Tokuda Naoki, Matsumaru Yuji, Matsumoto Shoji, Ohara Nobuyuki, Shindo Seigo, Takenobu Yohei, Yoshimoto Takeshi, Toyoda Kazunori, Uwatoko Takeshi, Yagita Yoshiki, Yamada Takehiro, Yamamoto Nobuaki, Yamamoto Ryoo, Yazawa Yukako, Sugiura Yuri, Waweru Peter Kuria, Baek Jang-Hyun, Lee Si Baek, Seo Kwon-Duk, Sohn Sung-Il, Arsovska Anita Ante, Chan Yong Chieh, Zaidi Wan Asyraf Wan, Jaafar Ainul Syahrilfazli, Gongora-Rivera Fernando, Martinez-Marino Manuel, Infante-Valenzuela Adrian, Groppa Stanislav, Leahu Pavel, Coutinho Jonathan M., Rinkel Leon A., Dippel Diederik W.J., van Dam-Nolen Dianne H.K., Ranta Annemarei, Wu Teddy Y., Adebayo Tajudeen Temitayo, Bello Abiodun H., Nwazor Ernest Okwundu, Sunmonu Taofiki Ajao, Wahab Kolawole Wasiu, Ronning Ole Morten, Sandset Else Charlotte, Al Hashmi Amal M., Ahmad Saima, Rashid Umair, Rodriguez-Kadota Liliana, Vences Miguel Ángel, Yalung Patrick Matic, Dy Jon Stewart Hao, Pineda-Franks Maria Carissa, Co Christian Oliver, Brola Waldemar, Debiec Aleksander, Dorobek Malgorzata, Karlinski Michal Adam, Labuz-Roszak Beata M., Lasek-Bal Anetta, Sienkiewicz-Jarosz Halina, Staszewski Jacek, Sobolewski Piotr, Wiacek Marcin, Zielinska-Turek Justyna, Araujo Andre Pinho, Rocha Mariana, Castro Pedro, Cruz Vitor Tedim, Ferreira Paulo Venancio, Ferreira Patricia, Nunes Ana Paiva, Fonseca Luisa, Marto João Pedro, Pinho e Melo Teresa, Rodrigues Miguel, Silva M. Luis, Dimitriade Adela, Falup-Pecurariu Cristian, Adel Hamid May, Venketasubramanian Narayanaswamy, Krastev Georgi, Mako Miroslav, Ayo-Martin Oscar, Hernández-Fernández Francisco, Blasco Jordi, Rodríguez-Vázquez Alejandro, Cruz-Culebras Antonio, Moniche Francisco, Montaner Joan, Perez-Sanchez Soledad, Sánchez María Jesús García, Rodríguez Marta Guillán, Jood Katarina, Nordanstig Annika, Mazya Michael V., Moreira Tiago T.P., Bernava Gianmarco, Beyeler Morin, Bolognese Manuel, Carrera Emmanuel, Dobrocky Tomas, Karwacki Grzegorz Marek, Keller Emanuela, Hsieh Chang Yang, Boonyakarnkul Surawan, Churojana Anchalee, Aykac Ozlem, Ã-zcan Ozdemir Atilla, Bajrami Arsida, Senadim Songul, Hussain Syed Irteza, John Seby, Banerjee Soma, Kwan Joseph, Krishnan Kailash, Lenthall Robert, Matthews Ashok, Wong Ken, Zhang Liqun, Altschul Dorothea, Asif Kaiz S., Bahiru Zeelalem, Below Kristine, Biller José, Ruland Sean, Chaudry Saqib A., Chen Michael, Chebl Alex, Cibulka Jackie, Cistrunk Leon, Clark Judith, Colasurdo Marco, Czap Alexandra, de Havenon Adam, D'Amato Salvatore, Dharmadhikari Sushrut, Grimmett Kasey B., Dmytriw Adam A., Etherton Mark R., Ezepue Chizoba, Farooqui Mudassir, Feske Steven K., Fink Lauren, Gasimova Ulviyya, Guzik Amy K., Hakemi Maryam, Hovingh Majesta, Khan Muhib, Jillela Dinesh, Kan Peter T., Khatri Rakesh, Khawaja Ayaz M., Khoury Naim N., Kiley Nicole L., Kim Benny S., Kolikonda Murali K., Kuhn Anna Luisa, Lara Stephanie, Linares Guillermo, Linfante Italo, Lukovits Timothy G., Lycan Sarah, Male Shailesh S., Maali Laith, Mancin John, Masoud Hesham, Mohamed Ghada A., Monteiro Andre, Nahab Fadi, Nalleballe Krishna, Ortega-Gutierrez Santiago, Puri Ajit S., Radaideh Yazan, Rahangdale Rahul H., Rai Ansaar, Ramakrishnan Pankajavalli, Reddy Aravind B., Rojas-Soto Diana M., Romero Jose Rafael, Rost Natalia S., Rothstein Aaron, Omran Setareh Salehi, Sheth Sunil A., Siddiqui Adnan H., Starosciak Amy K., Tarlov Nicholas E., Taylor Robert A., Wang Michael J., Wolfe Jared, Wong Ka-Ho, Le Huynh Vu, Nguyen Quy Viet, Pham Thong Nhu, Nguyen Trung Thanh, Phan Hoang Thi, Ton Mai Duy, Fischer Urs, Michel Patrik, Strambo Davide, Martins Sheila O., Zaidat Osama O., Nogueira Raul G., and the SVIN COVID-19 Global Stroke Registry
Publisher: Lippincott Williams and Wilkins
Publication year: 2023
Journal: Neurology
Journal name in source: Neurology
Volume: 100
Issue: 4
First page : e408
Last page: e421
eISSN: 1526-632X
DOI: https://doi.org/10.1212/WNL.0000000000201426
Self-archived copy’s web address: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9897052/
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.
