New England Center for Stroke Research; Department of Radiology
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
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Copyright © 2021. Authors' accepted manuscript posted with a CC BY-NC-ND license as allowed by the publisher's author archiving and green open access guidelines at https://uk.sagepub.com/en-gb/eur/posting-to-an-institutional-repository-green-open-access.
DOI of Published Version
Nogueira R, Abdalkader M, Qureshi MM, Frankel MR, Mansour OY, Yamagami H, Qiu Z, Farhoudi M, Siegler JE, Yaghi S, Raz E, Sakai N, Ohara N, Piotin M, Mechtouff L, Eker O, Chalumeau V, Kleinig T, Liu JM, Pop R, Winters HS, Shang X, Rodriguez Vasquez A, Blasco J, Arenillas JF, Martinez-Galdamez M, Brehm A, Psychogios M, Lylyk P, Haussen DC, Al-Bayati A, Mohammaden MH, Fonseca L, Silva MLS, Montalverne FJ, Lima FO, Renieri L, Mangiafico S, Fischer U, Gralla J, Frei D, Chugh C, Mehta BP, Nagel S, MÃ Hlenbruch M, Ortega S, Farooqui M, Hassan AE, Taylor A, Lapergue B, Consoli A, Campbell B, Sharma M, Walker M, van Horn N, Fiehler J, Nguyen HT, Nguyen QT, Watanabe D, Zhang H, Le HV, Nguyen VQ, Shah R, Devlin T, Khandelwal P, Linfante I, Izzath W, Lavados P, OlavarrÃ A VV, Sampaio Silva G, Verena de Carvalho Sousa A, Kirmani J, Bendszus M, Amano T, Yamamoto R, Doijiri R, Tokuda N, Yamada T, Terasaki T, Yazawa Y, Morris JG, Griffin E, Thornton J, Lavoie P, Matouk C, Hill MD, Demchuk AM, Killer M, Nahab F, Altschul D, Perez de la Ossa N, Kikano R, Boisseau W, Walker G, Cordina S, Puri AS, Kuhn A, Gandhi D, Nguyen T. EXPRESS: Global Impact of the COVID-19 Pandemic on Stroke Hospitalizations and Mechanical Thrombectomy Volumes. Int J Stroke. 2021 Jan 18:1747493021991652. doi: 10.1177/1747493021991652. Epub ahead of print. PMID: 33459583. Link to article on publisher's site
International journal of stroke : official journal of the International Stroke Society
Nogueira R, Puri AS, Kuhn AL, Nguyen T. (2021). EXPRESS: Global Impact of the COVID-19 Pandemic on Stroke Hospitalizations and Mechanical Thrombectomy Volumes. COVID-19 Publications by UMMS Authors. https://doi.org/10.1177/1747493021991652. Retrieved from https://escholarship.umassmed.edu/covid19/173
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