E-008 Variation in subarachnoid hemorrhage presentation and demographics in California during the COVID-19 pandemic: A UC stroke consortium study

E-008 Figure 2Relative fraction of Hispanic patients with SAH by COVID19 status across the UC Health systems. Dashed line indicates equal portion of COVID(+) and COVID (-) patients;centers below the dashed line had lower fraction of COVID(+) SAH patients and those above the line had higher fraction of COVID19(+) (*p<0.1)[Figure omitted. See PDF]ConclusionsCOVID19(+) patients presenting with SAH were younger than COVID(-) controls, and there was a trend toward underrepresentation of Hispanic patients in the COVID(+) group. Recognizing COVID19 status as a factor in SAH presentation is important to mitigate healthcare disparities in California.DisclosuresA. Gautam: None. T. Caton: None. K. Narsinh: None. A. Baker: None. S. Hetts: None. D. Cooke: None.

Global impact of the COVID-19 pandemic on subarachnoid hemorrhage

Introduction: During the COVID-19 pandemic, decreased volumes of stroke admissions and mechanical thrombectomy were reported. The objective was to examine whether subarachnoid hemorrhage(SAH) hospitalizations and ruptured aneurysm coiling interventions demonstrated similar declines. Methods: We conducted a global, retrospective, observational study across 6 continents, 37 countries, and 140 comprehensive stroke centers. Patients with diagnosis of SAH, ruptured aneurysm coiling interventions, COVID-19 were identified using ICD-10 codes or by prospectively maintained stroke databases. The 3-month cumulative volume, monthly volumes for SAH hospitalizations and ruptured aneurysm coiling procedures were compared for the period before (1- year and immediately before) and during the COVID-19 pandemic (March 1 to May 31, 2020). Results: There was a significant decline in SAH hospitalizations with 2,044 admissions in the 3 months immediately before and 1,585 admissions during the pandemic, representing a decline of 22.5% (95%CI, -24.3 to -20.7, p<0.0001). Embolization of ruptured aneurysms declined with 1,170 to 1,035 procedures, respectively, representing an 11.5%(95%CI, -13.5 to -9.8, p=0.002) drop. Hospitals with higher COVID-19 hospitalization burden demonstrated greater declines in SAH and ruptured aneurysm coiling compared to lower COVID-19 burden. A relative increase in coiling of ruptured aneurysms was noted in low coiling volume hospitals of 41.1% (95%CI, 32.3-50.6, p=0.008) despite a decrease in SAH admissions in this tertile. Conclusions: There was a global decrease in subarachnoid hemorrhage admissions and ruptured aneurysm embolizations during the COVID-19 pandemic. Among low-volume coiling SAH hospitals, there was an increase in the ruptured aneurysm coiling intervention. These findings in SAH are consistent with a global decrease in other emergencies such as stroke and myocardial infarction.