TY - JOUR
T1 - Global Effect of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events A 1-Year Follow-up
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 - Conforto, Adriana Bastos
AU - Hidalgo, Raquel C. T.
AU - de Oliveira Neves, Luciana
AU - Martins, Rodrigo Targa
AU - Cuervo, Daissy Liliana Mora
AU - Rebello, Leticia C.
AU - Santiago, Igor Bessa
AU - da Silva, Isabelle Lameirinhas
AU - Sakelarova, Teodora
AU - Kalpachki, Rosen
AU - Alexiev, Filip
AU - Catanese, Luciana
AU - Cora, Elena Adela
AU - Goyal, Mayank
AU - Hill, Michael D.
AU - Kelly, Michael E.
AU - Khosravani, Houman
AU - Lavoie, Pascale
AU - Peeling, Lissa
AU - Pikula, Aleksandra
AU - Rivera, Rodrigo
AU - Chen, Hui-Sheng
AU - Chen, Yimin
AU - Huo, Xiaochuan
AU - Miao, Zhongrong
AU - Yang, Shuiquan
AU - Bedekovic, Marina Roje
AU - Bralic, Marina
AU - Budincevic, Hrvoje
AU - Corredor-Quintero, Angel Basilio
AU - Lara-Sarabia, Osvaldo E.
AU - Cabal, Martin
AU - Tenora, Dusan
AU - Fibrich, Petr
AU - Herzig, Roman
AU - Hlaváčová, Helena
AU - Hrabanovska, Emanuela
AU - Hlinovsky, David
AU - Jurak, Lubomir
AU - Kadlcikova, Jana
AU - Karpowicz, Igor
AU - Klecka, Lukas
AU - Kovar, Martin
AU - Lauer, David
AU - Neumann, Jiri
AU - Palouskova, Hana
AU - Reiser, Martin
AU - Rekova, Petra
AU - Rohan, Vladimir
AU - Skoda, Ondrej
AU - Skorna, Miroslav
AU - Sobotková, Lenka
AU - Sramek, Martin
AU - Zakova, Lenka
AU - Christensen, Hanne
AU - Drenck, Nicolas
AU - Iversen, Helle Klingenberg
AU - Truelsen, Thomas Clement
AU - Wienecke, Troels
AU - Sobh, Khalid
AU - Ylikotila, Pauli
AU - Alpay, Kemal
AU - Strbian, Daniel
AU - Bernady, Patricia
AU - Casenave, Philippe
AU - Dan, Maria
AU - Faucheux, Jean-Marc
AU - Gentric, Jean-Christophe
AU - Magro, Elsa
AU - Sabben, Candice
AU - Reiner, Peggy
AU - Rouanet, Francois
AU - Bohmann, Ferdinand O.
AU - Boskamp, Stefan
AU - Mbroh, Joshua
AU - Nagel, Simon
AU - Nolte, Christian H.
AU - Ringleb, Peter A.
AU - Rosenkranz, Michael
AU - Poli, Sven
AU - Thomalla, G. tz
AU - Karapanayiotides, Theodoros
AU - Koutroulou, Ioanna
AU - Kargiotis, Odysseas
AU - Palaiodimou, Lina
AU - Guerra, Jose Dominguo Barrientos
AU - Huded, Vikram
AU - Menon, Bindu
AU - Nagendra, Shashank
AU - Prajapati, Chintan
AU - Sylaja, P. N.
AU - Pramana, Nyoman Angga Krishna
AU - Sani, Achmad Firdaus
AU - Ghoreishi, Abdoreza
AU - Farhoudi, Mehdi
AU - Hokmabadi, Elyar Sadeghi
AU - Raya, Tariq Abu
AU - Kalmanovich, Shani Avnery
AU - Ronen, Levite
AU - Sabetay, Sergiu Ionut
AU - Acampa, Maurizio
AU - Adami, Alessandro
AU - Castellan, Lucio
AU - Longoni, Marco
AU - Ornello, Raffaele
AU - Renieri, Leonardo
AU - Bigliani, Claudia Rolla
AU - Romoli, Michele
AU - Sacco, Simona
AU - Salmaggi, Andrea
AU - Sangalli, Davide
AU - Zini, Andrea
AU - Doijiri, Ryosuke
AU - Fukuda, Hiroki
AU - Fujinaka, Toshiyuki
AU - Fujita, Kyohei
AU - Imamura, Hirotoshi
AU - Sakai, Nobuyuki
AU - Kanamaru, Takuya
AU - Kimura, Naoto
AU - Kono, Ryuhei
AU - Miyake, Kosuke
AU - Sakaguchi, Manabu
AU - Sakai, Kenichiro
AU - Sonoda, Kazutaka
AU - Todo, Kenichi
AU - Miyashita, Fumio
AU - Tokuda, Naoki
AU - Matsumaru, Yuji
AU - Matsumoto, Shoji
AU - Ohara, Nobuyuki
AU - Shindo, Seigo
AU - Takenobu, Yohei
AU - Yoshimoto, Takeshi
AU - Toyoda, Kazunori
AU - Uwatoko, Takeshi
AU - Yagita, Yoshiki
AU - Yamada, Takehiro
AU - Yamamoto, Nobuaki
AU - Yamamoto, Ryoo
AU - Yazawa, Yukako
AU - Sugiura, Yuri
AU - Waweru, Peter Kuria
AU - Baek, Jang-Hyun
AU - Lee, Si Baek
AU - Seo, Kwon-Duk
AU - Sohn, Sung-Il
AU - Arsovska, Anita Ante
AU - Chan, Yong Chieh
AU - Zaidi, Wan Asyraf Wan
AU - Jaafar, Ainul Syahrilfazli
AU - Gongora-Rivera, Fernando
AU - Martinez-Marino, Manuel
AU - Infante-Valenzuela, Adrian
AU - Groppa, Stanislav
AU - Leahu, Pavel
AU - Coutinho, Jonathan M.
AU - Rinkel, Leon A.
AU - Dippel, Diederik W. J.
AU - van Dam-Nolen, Dianne H. K.
AU - Ranta, Annemarei
AU - Wu, Teddy Y.
AU - Adebayo, Tajudeen Temitayo
AU - Bello, Abiodun H.
AU - Nwazor, Ernest Okwundu
AU - Sunmonu, Taofiki Ajao
AU - Wahab, Kolawole Wasiu
AU - Ronning, Ole Morten
AU - Sandset, Else Charlotte
AU - Al Hashmi, Amal M.
AU - Ahmad, Saima
AU - Rashid, Umair
AU - Rodriguez-Kadota, Liliana
AU - Vences, Miguel Ángel
AU - Yalung, Patrick Matic
AU - Dy, Jon Stewart Hao
AU - Pineda-Franks, Maria Carissa
AU - Co, Christian Oliver
AU - Brola, Waldemar
AU - Debiec, Aleksander
AU - Dorobek, Malgorzata
AU - Karlinski, Michal Adam
AU - Labuz-Roszak, Beata M.
AU - Lasek-Bal, Anetta
AU - Sienkiewicz-Jarosz, Halina
AU - Staszewski, Jacek
AU - Sobolewski, Piotr
AU - Wiacek, Marcin
AU - Zielinska-Turek, Justyna
AU - Araujo, Andre Pinho
AU - Rocha, Mariana
AU - Castro, Pedro
AU - Cruz, Vitor Tedim
AU - Ferreira, Paulo Venancio
AU - Ferreira, Patricia
AU - Nunes, Ana Paiva
AU - Fonseca, Luisa
AU - Marto, João Pedro
AU - Pinho e Melo, Teresa
AU - Rodrigues, Miguel
AU - Silva, M. Luis
AU - Dimitriade, Adela
AU - Falup-Pecurariu, Cristian
AU - Adel Hamid, May
AU - Venketasubramanian, Narayanaswamy
AU - Krastev, Georgi
AU - Mako, Miroslav
AU - Ayo-Martin, Oscar
AU - Hernández-Fernández, Francisco
AU - Blasco, Jordi
AU - Rodríguez-Vázquez, Alejandro
AU - Cruz-Culebras, Antonio
AU - Moniche, Francisco
AU - Montaner, Joan
AU - Perez-Sanchez, Soledad
AU - Sánchez, María Jesús García
AU - Rodríguez, Marta Guillán
AU - Jood, Katarina
AU - Nordanstig, Annika
AU - Mazya, Michael V.
AU - Moreira, Tiago T. P.
AU - Bernava, Gianmarco
AU - Beyeler, Morin
AU - Bolognese, Manuel
AU - Carrera, Emmanuel
AU - Dobrocky, Tomas
AU - Karwacki, Grzegorz Marek
AU - Keller, Emanuela
AU - Hsieh, Chang Yang
AU - Boonyakarnkul, Surawan
AU - Churojana, Anchalee
AU - Aykac, Ozlem
AU - Ã-Zcan Ozdemir, Atilla
AU - Bajrami, Arsida
AU - Senadim, Songul
AU - Hussain, Syed Irteza
AU - John, Seby
AU - Banerjee, Soma
AU - Kwan, Joseph
AU - Krishnan, Kailash
AU - Lenthall, Robert
AU - Matthews, Ashok
AU - Wong, Ken
AU - Zhang, Liqun
AU - Altschul, Dorothea
AU - Asif, Kaiz S.
AU - Bahiru, Zeelalem
AU - Below, Kristine
AU - Biller, José
AU - Ruland, Sean
AU - Chaudry, Saqib A.
AU - Chen, Michael
AU - Chebl, Alex
AU - Cibulka, Jackie
AU - Cistrunk, Leon
AU - Clark, Judith
AU - Colasurdo, Marco
AU - Czap, Alexandra
AU - de Havenon, Adam
AU - D'Amato, Salvatore
AU - Dharmadhikari, Sushrut
AU - Grimmett, Kasey B.
AU - Dmytriw, Adam A.
AU - Etherton, Mark R.
AU - Ezepue, Chizoba
AU - Farooqui, Mudassir
AU - Feske, Steven K.
AU - Fink, Lauren
AU - Gasimova, Ulviyya
AU - Guzik, Amy K.
AU - Hakemi, Maryam
AU - Hovingh, Majesta
AU - Khan, Muhib
AU - Jillela, Dinesh
AU - Kan, Peter T.
AU - Khatri, Rakesh
AU - Khawaja, Ayaz M.
AU - Khoury, Naim N.
AU - Kiley, Nicole L.
AU - Kim, Benny S.
AU - Kolikonda, Murali K.
AU - Kuhn, Anna Luisa
AU - Lara, Stephanie
AU - Linares, Guillermo
AU - Linfante, Italo
AU - Lukovits, Timothy G.
AU - Lycan, Sarah
AU - Male, Shailesh S.
AU - Maali, Laith
AU - Mancin, John
AU - Masoud, Hesham
AU - Mohamed, Ghada A.
AU - Monteiro, Andre
AU - Nahab, Fadi
AU - Nalleballe, Krishna
AU - Ortega-Gutierrez, Santiago
AU - Puri, Ajit S.
AU - Radaideh, Yazan
AU - Rahangdale, Rahul H.
AU - Rai, Ansaar
AU - Ramakrishnan, Pankajavalli
AU - Reddy, Aravind B.
AU - Rojas-Soto, Diana M.
AU - Romero, Jose Rafael
AU - Rost, Natalia S.
AU - Rothstein, Aaron
AU - Omran, Setareh Salehi
AU - Sheth, Sunil A.
AU - Siddiqui, Adnan H.
AU - Starosciak, Amy K.
AU - Tarlov, Nicholas E.
AU - Taylor, Robert A.
AU - Wang, Michael J.
AU - Wolfe, Jared
AU - Wong, Ka-Ho
AU - le, Huynh Vu
AU - Nguyen, Quy Viet
AU - Pham, Thong Nhu
AU - Nguyen, Trung Thanh
AU - Phan, Hoang Thi
AU - Ton, Mai Duy
AU - Fischer, Urs
AU - Michel, Patrik
AU - Strambo, Davide
AU - Martins, Sheila O.
AU - Zaidat, Osama O.
AU - SVIN COVID-19 Global Stroke Registry
AU - Nogueira, Raul G.
N1 - Funding Information:
This was an investigator-initiated study. As this was a continuation of our prior work, the institutional review boards from the coordinating sites (Emory University and Boston Medical Center) considered that the investigators did not have access to protected health information in this follow-up study, and thus, no IRB oversight was required because the study did not meet the US federal description of human subject research. Site-specific IRB approval was obtained where required by local regulations or institutional policy. There was no protective health information data included in this study. The study was funded by the Society of Vascular and Interventional Neurology research pilot grant. This study was registered under NCT04934020.
Funding Information:
The authors acknowledge the following contributors for participating in data collection: Megan Brady, MPH, MSW (Henry Ford); Dawn Scozzari, RHIT (Henry Ford); Elisabeth Dirren, MD (Geneva University Hospitals, Geneva, Switzerland); Claudio Rodríguez Fernández (Hospital Universitario Rey Juan Carlos); Jorge Escartín López (Hospital Universitario Rey Juan Carlos); José Fernández-Ferro (Hospital Universitario Rey Juan Carlos); Beatriz de la Cruz Fernández (Hospital Universitario Rey Juan Carlos); Niloofar Mohammadzadeh as data entry staff in Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Filipe Bessa, MD (Hospital de Santa Maria-Centro Hospitalar Lisboa Norte, Portugal); Nina Jancar, MD (Hospital de Santa Maria-Centro Hospitalar Lisboa Norte, Portugal); and Neil C. Suryadevara, MD (SUNY Upstate, NY).
Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/1/24
Y1 - 2023/1/24
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.
UR - https://www.scopus.com/pages/publications/85147770827
U2 - 10.1212/WNL.0000000000201426
DO - 10.1212/WNL.0000000000201426
M3 - Article
C2 - 36257718
SN - 0028-3878
VL - 100
SP - E408-E421
JO - Neurology
JF - Neurology
IS - 4
ER -
SDG 3 Good Health and Well-being