ABSTRACT
Background: Prior studies indicated a decrease in the incidences of subarachnoid hemorrhage (SAH) during the early stages of the COVID- 19 pandemic. We evaluated differences in the incidence, severity of SAH presentation, and ruptured aneurysm treatment modality during the 1st year of the COVID-19 pandemic compared to the preceding year. Methods: We conducted a cross-sectional study including 49 countries and 187 centers. We recorded volumes for: COVID-19 hospitalizations, SAH hospitalizations, Hunt-Hess Grade, coiling, clipping, and aneurysmal SAH (aSAH) in-hospital mortality. Diagnoses were identified by ICD-10 codes or stroke databases from January 2019 to May 2021. Results: Over the study period, there were 16,247 aSAH admissions, 344,491 COVID-19 admissions, 8,300 coiling and 4,240 aneurysmal clipping procedures. Declines were observed in aSAH admissions (-6.4% [95%CI -7,-5.8];p=0.0001) during the first year of the pandemic compared to the prior year, most pronounced in high-volume SAH and highvolume COVID-19 hospitals. There was a trend towards a decline in mild and moderate presentation of aSAH (mild: -5%[-5.9,-4.3], p=0.06;moderate: -8.3%[-10.2,-6.7], p=0.06) but no difference in higher SAH severity. The clipping rate remained unchanged (30.7% vs. 31.2%, p=0.58), whereas coiling increased (53.97%vs.56.5%, p=0.009). There was no difference in aSAH in-hospital mortality rate (19.1% vs 20.1%,p=0.12). Conclusion: During the first year of the pandemic, there was a decrease in aSAH admissions volume driven by a decrease in mild to moderate presentation of aSAH. There was an increase in the coiling rate, but no change in clipping rate, nor change in aSAH in-hospital mortality.
ABSTRACT
Background. In December 2019, SARS-CoV-2 or coronavirus disease 2019 (COVID-19) emerged from Wuhan, China. A global pandemic quickly unfolded, infecting >137 million people and causing >2.9 million deaths globally as of April 13, 2021. Before April 1, 2020, there were only five confirmed COVID-19 cases in Nepal. Like many countries around the world, the COVID-19 situation quickly escalated in Nepal. The purpose of this study was to determine the trends in COVID-19 cases and deaths in Nepal from April 2020 to March 2021. Methods. We utilized epidemiological data from daily Situation Reports published by the Ministry of Health and Population (MOHP) of Nepal. Data were extracted or calculated from April 1, 2020 to March 31, 2021. Primary variables of interest were national and provincial daily cases, total cases, daily deaths, and total deaths. Results. Between April 1, 2020 to March 31, 2021, there were 277,304 cases. October 2020 had the highest monthly cases with 92,926 cases. During the one-year study period, the infection rate was 915 cases per 100,000 people. The largest single-day new cases was October 21, 2020 with 5,743 cases, which is calculated to 19 cases per 100,000 people. There were a total of 3,030 deaths. The largest daily new deaths was November 4, 2020 with 43 cases. June 10, 2020 had the highest number of people in quarantine with 172,266 people. October 23, 2020 had the highest number of active cases with 46,329 cases. By March 31, 2021, the percent of mortality was 1.1%, active infection was 0.5%, and recovery was 98.4%. Conclusion. Nepal had lower COVID-19 infection and case-fatality rates compared to other countries most affected by the pandemic. This was due to several factors, most notably early implementation of strict lockdown measures and closing of international borders on March 24, 2020 after the second confirmed COVID-19 case. As lockdown restrictions were lifted on July 7, 2020, COVID-19 cases and deaths in Nepal rose rapidly. As vaccination begun on January 27, 2021, cases started to slow down until the most recent outbreak coinciding with the second wave in its neighboring country, India. Now, infection and case-fatality rates in Nepal are at an all-time high, prompting further lockdowns on April 29, 2021.
ABSTRACT
The Coronavirus disease 2019 (COVID-19) outbreak was first discovered in Wuhan, China, and it has since spread to more than 200 countries. The World Health Organization proclaimed COVID-19 a public health emergency of international concern on January 30, 2020. Normally, a quickly spreading infection that could jeopardize the well-being of countless individuals requires prompt action to forestall the malady in a timely manner. COVID-19 is a major threat worldwide due to its ability to rapidly spread. No vaccines are yet available for COVID-19. The objective of this paper is to examine the worldwide COVID-19 pandemic, specifically studying Hubei Province, China;Taiwan;South Korea;Japan;and Italy, in terms of exposed, infected, recovered/deceased, original confirmed cases, and predict confirmed cases in specific countries by using the susceptible-exposed-infectious-recovered model to predict the future outbreak of COVID-19. We applied four differential equations to calculate the number of confirmed cases in each country, plotted them on a graph, and then applied polynomial regression with the logic of multiple linear regression to predict the further spread of the pandemic. We also compared the calculated and predicted cases of confirmed population and plotted them in the graph, where we could see that the lines of calculated and predicted cases do intersect with each other to give the perfect true results for the future spread of the virus. This study considered the cases from 22 January 2020 to 25 April 2020.