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Global Impact of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events: One-Year Follow-up.
Nguyen, Thanh N; Qureshi, Muhammad M; Klein, Piers; Yamagami, Hiroshi; Mikulik, Robert; Czlonkowska, Anna; Abdalkader, Mohamad; Sedova, Petra; Sathya, Anvitha; Lo, Hannah C; Mansour, Ossama Yassin; Vanguru, Husitha Reddy; Lesaine, Emilie; Tsivgoulis, Georgios; Loochtan, Aaron I; Demeestere, Jelle; Uchino, Ken; Inoa, Violiza; Goyal, Nitin; Charidimou, Andreas; Siegler, James E; Yaghi, Shadi; Aguiar de Sousa, Diana; Mohammaden, Mahmoud; Haussen, Diogo C; Kristoffersen, Espen Saxhaug; Lereis, Virginia Pujol; Scollo, Sergio Daniel; Campbell, Bruce C V; Ma, Alice; Thomas, James Orton; Parsons, Mark W; Singhal, Shaloo; Slater, Lee-Anne; Martins, Rodrigo Tomazini; Enzinger, Chris; Gattringer, Thomas; Rahman, Aminur; Bonnet, Thomas; Ligot, Noemie; De Raedt, Sylvie; Lemmens, Robin; Vanacker, Peter; Vandervorst, Fenne; Conforto, Adriana Bastos; Hidalgo, Raquel C T; de Oliveira Neves, Luciana; Martins, Rodrigo Targa; Mora Cuervo, Daissy Liliana; Rebello, Leticia C.
  • Nguyen TN; Department of Neurology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine. thanh.nguyen@bmc.org.
  • Qureshi MM; Department of Radiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine.
  • Klein P; Department of Radiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine.
  • Yamagami H; Department of Radiation Oncology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine.
  • Mikulik R; Department of Neurology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine.
  • Czlonkowska A; Department of Radiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine.
  • Abdalkader M; Department of Stroke Neurology, National Hospital Organization, Osaka National Hospital, Japan.
  • Sedova P; Department of Neurology, International Clinical Research Centre, St Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
  • Sathya A; 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.
  • Lo HC; Department of Radiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine.
  • Mansour OY; Department of Neurology, International Clinical Research Centre, St Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
  • Vanguru HR; Department of Internal Medicine and Cardiology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
  • Lesaine E; Department of Neurology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine.
  • Tsivgoulis G; Department of Radiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine.
  • Loochtan AI; Department of Neurology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine.
  • Demeestere J; Department of Radiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine.
  • Uchino K; Department of Neurology, Alexandria University Stroke and Neurointervention Unit, Alexandria, Egypt.
  • Inoa V; Department of Neurology, Cleveland Clinic, USA.
  • Goyal N; Centre Hospitalier de l'Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France.
  • Charidimou A; Second Department of Neurology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
  • Siegler JE; Ohio Health Riverside Methodist Hospital, USA.
  • Yaghi S; Neurology Department, Leuven University Hospital, Leuven, Belgium.
  • Aguiar de Sousa D; Department of Neurology, Cleveland Clinic, USA.
  • Mohammaden M; University of Tennessee Health Science Center, Tennessee, USA.
  • Haussen DC; University of Tennessee Health Science Center, Tennessee, USA.
  • Kristoffersen ES; Department of Neurology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine.
  • Lereis VP; Cooper Neurological Institute, Cooper University Hospital, Camden, NJ, USA.
  • Scollo SD; Department of Neurology, Rhode Island Hospital, Brown University, Providence, Rhode Island.
  • Campbell BCV; Stroke Center, Centro Hospitalar Universitário Lisboa Central - CHULC, Portugal, CEEM.
  • Ma A; Institute of Anatomy, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
  • Thomas JO; Department of Neurology, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, USA.
  • Parsons MW; Department of Neurology, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, USA.
  • Singhal S; Department of Neurology, Akershus University Hospital, University of Oslo, Oslo, Norway and Department of General Practice, University of Oslo, Norway.
  • Slater LA; Division de Neurologia Vascular, Departmento de Neurologia, Institute for Neurological Research - FLENI, Buenos Aires, Argentina.
  • Martins RT; Stroke Unit, Ramos Mejia Hospital, Buenos Aires, Argentina.
  • Enzinger C; Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.
  • Gattringer T; Royal North Shore Hospital, Sydney, Australia.
  • Rahman A; Department of Neurophysiology, Liverpool Hospital, New South Wales, Australia.
  • Bonnet T; Department of Neurology, Liverpool Hospital, New South Wales, Australia.
  • Ligot N; Monash University, Melbourne, Australia.
  • De Raedt S; Monash University, Melbourne, Australia.
  • Lemmens R; Department of Neurology, Mater Hospital, Brisbane, Australia.
  • Vanacker P; Department of Neurology, Medical University of Graz, Graz, Austria.
  • Vandervorst F; Department of Neurology and Division of Neuroradiology, Vascular and Interventional Radiology, Medical University of Graz, Graz, Austria.
  • Conforto AB; Department of Neurology, Sir Salimullah Medical College, Mitford, Dhaka, Bangladesh.
  • Hidalgo RCT; Hopital Erasme, Brussels, Belgium.
  • de Oliveira Neves L; Hopital Erasme, Brussels, Belgium.
  • Martins RT; Department of Neurology, Universitair Ziekenhuis Brussel, Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium.
  • Mora Cuervo DL; Neurology Department, Leuven University Hospital, Leuven, Belgium.
  • Rebello LC; Department of Neurology, University Hospitals Antwerp; Department of Translational Neuroscience, University of Antwerp, Belgium.
Neurology ; 2022 Oct 18.
Article in English | MEDLINE | ID: covidwho-2233771
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.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Year: 2022 Document Type: Article