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 -