UMMS Affiliation

New England Center for Stroke Research; Department of Radiology

Publication Date


Document Type



Cardiovascular Diseases | Clinical Epidemiology | Epidemiology | Health Services Administration | Health Services Research | Infectious Disease | Nervous System Diseases | Virus Diseases


BACKGROUND: The COVID-19 pandemic led to profound changes in the organization of health care systems worldwide.

AIMS: We sought to measure the global impact of the COVID-19 pandemic on the volumes for mechanical thrombectomy (MT), stroke, and intracranial hemorrhage (ICH) hospitalizations over a 3-month period at the height of the pandemic (March 1 to May 31, 2020) compared with two control 3-month periods (immediately preceding and one year prior).

METHODS: Retrospective, observational, international study, across 6 continents, 40 countries, and 187 comprehensive stroke centers. The diagnoses were identified by their ICD-10 codes and/or classifications in stroke databases at participating centers.

RESULTS: The hospitalization volumes for any stroke, ICH, and MT were 26,699, 4,002, and 5,191 in the 3 months immediately before versus 21,576, 3,540, and 4,533 during the first 3 pandemic months, representing declines of 19.2% (95%CI,-19.7 to -18.7), 11.5% (95%CI,-12.6 to -10.6), and 12.7% (95%CI,-13.6 to -11.8), respectively. The decreases were noted across centers with high, mid, and low COVID-19 hospitalization burden, and also across high, mid, and low volume stroke/MT centers. High-volume COVID-19 centers (-20.5%) had greater declines in MT volumes than mid- (-10.1%) and low-volume (-8.7%) centers (p < 0.0001). There was a 1.5% stroke rate across 54,366 COVID-19 hospitalizations. SARS-CoV-2 infection was noted in 3.9% (784/20,250) of all stroke admissions.

CONCLUSION: The COVID-19 pandemic was associated with a global decline in the volume of overall stroke hospitalizations, MT procedures, and ICH admission volumes. Despite geographic variations, these volume reductions were observed regardless of COVID-19 hospitalization burden and pre-pandemic stroke/MT volumes.


Acute stroke therapy, COVID-19, Epidemiology, Intracerebral hemorrahage, Ischaemic stroke, mechanical thrombectomy

Rights and Permissions

Copyright © 2021 World Stroke Organization. This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (

DOI of Published Version



SVIN COVID-19 global registry. Global impact of COVID-19 on stroke care. Int J Stroke. 2021 Mar 29:1747493021991652. doi: 10.1177/1747493021991652. Epub ahead of print. PMID: 33459583; PMCID: PMC8010375. Link to article on publisher's site

Journal/Book/Conference Title

International journal of stroke : official journal of the International Stroke Society


For the full list of authors, see article.

Related Resources

Link to Article in PubMed

PubMed ID


Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.