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Global Impact of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events

  • SVIN COVID-19 Global Stroke Registry
  • Boston University
  • Department of Radiology
  • Department of Neurology
  • Department of Radiation Oncology
  • Department of Stroke Neurology
  • National Hospital Organization Osaka National Hospital
  • Department of Neurology
  • Masaryk University
  • Institute of Psychiatry and Neurology, Warszawa
  • Department of Neurology
  • Alexandria University
  • Cleveland Clinic Foundation
  • Institut national de la santé et de la recherche médicale
  • Second Department of Neurology
  • Attikon University Hospital
  • KU Leuven
  • Neurology Department
  • Health Science Center
  • University of Tennessee
  • Cooper Neurological Institute
  • Cooper University Health Care
  • Brown University
  • Stroke Center
  • Centro Hospitalar Universitário de Lisboa Central
  • CEEM
  • University of Lisbon
  • Institute of Anatomy
  • Emory University
  • Department of Neurology
  • University of Oslo
  • Department of General Practice
  • Division de Neurologia Vascular
  • Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia
  • Stroke Unit
  • Hospital General de Agudos José María Ramos Mejía
  • Department of Medicine and Neurology
  • Royal Melbourne Hospital
  • Royal North Shore Hospital
  • Department of Neurophysiol-og
  • Liverpool Hospital
  • Department of Neurology
  • Department of Neurology
  • Monash Medical Centre
  • Stroke and Aging Research Group
  • Monash University
  • Department of Radiology
  • Department of Neurology
  • Mater Group
  • Department of Neurology Medical
  • University of Graz
  • Department of Neurology
  • Medical University of Graz
  • Department of Neurology
  • Sir Salimullah Medical College
  • Université libre de Bruxelles
  • Department of Neurology
  • Vrije Universiteit Brussel
  • Department of Neurology
  • University of Antwerp
  • Department of Translational Neuroscience
  • Hospital das Clínicas
  • Universidade de São Paulo
  • Department of Neurology and Interventional Neuroradiology
  • Hospital de Base
  • Department of Neurology
  • Hospital São Carlos
  • Stroke Unit
  • Hospital Nossa Senhora da Conceição
  • Hospital Moinhos de Vento
  • University of Ilorin

Research output: Contribution to journal › Article › peer-review

41 Citations (Scopus)

Abstract

Background and Objectives Declines in stroke admission, IV thrombolysis (IVT), 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 effect of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), IVT, and mechanical thrombectomy over a 1-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, IVT 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 1 year immediately before compared with 138,453 admissions during the 1-year pandemic, representing a 7% decline (95% CI [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 with 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 with 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.

Original languageEnglish
Pages (from-to)E408-E421
JournalNeurology
Volume100
Issue number4
DOIs
Publication statusPublished - 24 Jan 2023
Externally publishedYes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well-being

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