Title

Global Impact of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events: One-Year Follow-up.

Authors

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

Document Type

Article

Publication Date

10-18-2022

Publication Title

Neurology

Abstract

BACKGROUND AND OBJECTIVES: Declines in stroke admission, intravenous thrombolysis, 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 impact of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), intravenous thrombolysis (IVT), and mechanical thrombectomy over a one-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, intravenous thrombolysis 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 one-year immediately before compared to 138,453 admissions during the one-year pandemic, representing a 7% decline (95% confidence interval [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 to 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 to 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. TRIAL REGISTRATION INFORMATION: This study is registered under NCT04934020.

PubMed ID

36257718

ePublication

ePub ahead of print

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