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Global Impact of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events: One-Year Follow-up

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Author(s)
Thanh N. NguyenMuhammad M QureshiPiers KleinHiroshi YamagamiRobert MikulikAnna CzlonkowskaMohamad AbdalkaderPetra SedovaAnvitha SathyaHannah C. LoOssama Yassin MansourHusitha Reddy VanguruEmilie LesaineGeorgios TsivgoulisAaron I. LoochtanJelle DemeestereKen UchinoVioliza InoaNitin GoyalAndreas CharidimouJames E. SieglerShadi YaghiDiana Aguiar de SousaMahmoud MohammadenDiogo C HaussenEspen Saxhaug KristoffersenVirginia Pujol LereisSergio Daniel ScolloBruce C. V. CampbellAlice MaJames Orton ThomasMark W ParsonsShaloo SinghalLee-Anne SlaterRodrigo Tomazini MartinsChris EnzingerThomas GattringerAminur RahmanThomas BonnetNoemie LigotSylvie De RaedtRobin LemmensPeter VanackerFenne VandervorstAdriana Bastos ConfortoRaquel C.T. HidalgoLuciana de Oliveira NevesRodrigo Targa MartinsDaissy Liliana Mora CuervoLeticia C. RebelloIgor Bessa SantiagoIsabelle Lameirinhas da SilvaTeodora SakelarovaRosen KalpachkiFilip AlexievLuciana CataneseElena Adela CoraMayank GoyalMichael D. HillMichael E. KellyHouman KhosravaniPascale LavoieLissa PeelingAleksandra PikulaRodrigo RiveraHui-Sheng ChenYimin ChenXiaochuan HuoZhongrong MiaoShuiquan YangMarina Roje BedekovicMarina BralicHrvoje BudincevicAngel Basilio Corredor-QuinteroOsvaldo E. Lara-SarabiaMartin CabalDusan TenoraPetr FibrichRoman HerzigHelena HlaváčováEmanuela HrabanovskaDavid HlinovskyLubomir JurakJana KadlcikovaIgor KarpowiczLukas KleckaMartin KovarDavid LauerJiri NeumannHana PalouskovaMartin ReiserPetra RekovaVladimir RohanOndrej SkodaMiroslav ŠkorňaLenka SobotkováMartin SramekLenka ZakovaHanne ChristensenNicolas DrenckHelle Klingenberg IversenThomas Clement TruelsenTroels WieneckeKhalid SobhPauli YlikotilaKemal AlpayDaniel StrbianPatricia BernadyPhilippe CasenaveMaria DanJean-Marc FaucheuxJean-Christophe GentricElsa MagroCandice SabbenPeggy ReinerFrancois RouanetFerdinand O. BohmannStefan BoskampJoshua MbrohSimon NagelChristian NoltePeter A. RinglebMichael RosenkranzSven PoliGötz ThomallaTheodoros KarapanayiotidesIoanna KoutroulouOdysseas KargiotisLina PalaiodimouJose Dominguo Barrientos GuerraVikram HudedBindu MenonShashank NagendraChintan PrajapatiP.N. SylajaNyoman Angga Krishna PramanaAchmad Firdaus SaniAbdoreza GhoreishiMehdi FarhoudiElyar Sadeghi HokmabadiTariq Abu RayaShani Avnery KalmanovichLevite RonenSergiu Ionut SabetayMaurizio AcampaAlessandro AdamiLucio CastellanMarco LongoniRaffaele OrnelloLeonardo RenieriClaudia Rolla BiglianiMichele RomoliSimona SaccoAndrea SalmaggiDavide SangalliAndrea ZiniRyosuke DoijiriHiroki FukudaToshiyuki FujinakaKyohei FujitaHirotoshi ImamuraNobuyuki SakaiTakuya KanamaruNaoto KimuraRyuhei KonoKosuke MiyakeManabu SakaguchiKenichiro SakaiKazutaka SonodaKenichi TodoFumio MiyashitaNaoki TokudaYuji MatsumaruShoji MatsumotoNobuyuki OharaSeigo ShindoYohei TakenobuTakeshi YoshimotoKazunori ToyodaTakeshi UwatokoYoshiki YagitaTakehiro YamadaNobuaki YamamotoRyoo YamamotoYukako YazawaYuri SugiuraPeter Kuria WaweruJang-Hyun BaekSi Baek LeeKwon-Duk SeoSung-Il SohnAnita Ante ArsovskaYong Chieh ChanWan Asyraf Wan ZaidiAinul Syahrilfazli JaafarFernando Gongora-RiveraManuel Martinez-MarinoAdrian Infante-ValenzuelaStanislav GroppaPavel LeahuJonathan M. CoutinhoLeon A. RinkelDiederik W.J. DippelDianne H.K. van Dam-NolenAnnemarei RantaTeddy Y WuTajudeen Temitayo AdebayoAbiodun H. BelloErnest Okwundu NwazorTaofiki Ajao SunmonuKolawole Wasiu WahabOle Morten RonningElse Charlotte SandsetAmal M. Al HashimiSaima AhmadUmair RashidLiliana Rodriguez-KadotaMiguel Ángel VencesPatrick Matic YalungJon Stewart Hao DyMaria Carissa Pineda-FranksChristian Oliver CoWaldemar BrolaAleksander DebiecMalgorzata DorobekMichal Adam KarlinskiBeata M. Labuz-RoszakAnetta Lasek-BalHalina Sienkiewicz-JaroszJacek StaszewskiPiotr SobolewskiMarcin WiacekJustyna Zielinska-TurekAndre Pinho AraujoMariana RochaPedro CastroVitor Tedim CruzPaulo Venancio FerreiraPatricia FerreiraAna Paiva NunesLuisa FonsecaJoão Pedro MartoTeresa Pinho e MeloMiguel RodriguesM Luis SilvaAdela DimitriadeCristian Falup-PecurariuMay Adel HamidNarayanaswamy VenketasubramanianGeorgi KrastevMiroslav MakoOscar Ayo-MartinFrancisco Hernández-FernándezJordi BlascoAlejandro Rodríguez-VázquezAntonio Cruz-CulebrasFrancisco MonicheJoan MontanerSoledad Perez-SanchezMaría Jesús García SánchezMarta Guillán RodríguezKatarina JoodAnnika NordanstigMichael V. MazyaTiago T.P. MoreiraGianmarco BernavaMorin BeyelerManuel BologneseEmmanuel CarreraTomas DobrockyGrzegorz Marek KarwackiEmanuela KellerChang Yang HsiehSurawan BoonyakarnkulAnchalee ChurojanaOzlem AykacAtilla OzdemirArsida BajramiSongul SenadimSyed Irteza HussainSeby JohnSoma BanerjeeJoseph KwanKailash KrishnanRobert LenthallAshok MatthewsKen WongLiqun ZhangDorothea AltschulKaiz S. AsifZeelalem BahiruKristine BelowJosé BillerSean RulandSaqib A. ChaudryMichael ChenAlex CheblJackie CibulkaLeon CistrunkJudith ClarkMarco ColasurdoAlexandra CzapAdam de HavenonSalvatore D'AmatoSushrut DharmadhikariKasey B. GrimmettAdam A DmytriwMark R EthertonChizoba EzepueMudassir FarooquiSteven K. FeskeLauren FinkUlviyya GasimovaAmy K. GuzikMaryam HakemiMajesta HovinghMuhib KhanDinesh JillelaPeter T. KanRakesh KhatriAyaz M. KhawajaNaim N. KhouryNicole L. KileyBenny S. KimMurali K. KolikondaAnna Luisa KuhnStephanie LaraGuillermo LinaresItalo LinfanteTimothy G. LukovitsSarah LycanShailesh S. MaleLaith MaaliJohn MancinHesham MasoudGhada A. MohamedAndre MonteiroFadi NahabKrishna NalleballeSantiago Ortega GutierrezAjit S. PuriYazan RadaidehRahul H. RahangdaleAnsaar RaiPankajavalli RamakrishnanAravind B. ReddyDiana M. Rojas-SotoJose Rafael RomeroNatalia S RostAaron RothsteinSetareh Salehi OmranSunil A. ShethAdnan H. SiddiquiAmy K. StarosciakNicholas E. TarlovRobert A. TaylorMichael J. WangJared WolfeKa-Ho WongHuynh Vu LeQuy Viet NguyenThong Nhu PhamTrung Thanh NguyenHoang Thi PhanMai Duy TonUrs FischerPatrik MichelDavide StramboSheila O. MartinsOsama O. ZaidatRaul G Nogueira
Keimyung Author(s)
Sohn, Sung Il
Department
Dept. of Neurology (신경과학)
Journal Title
Neurology
Issued Date
2023
Volume
100
Issue
4
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.

Trial registration information:
This study is registered under NCT04934020.
Keimyung Author(s)(Kor)
손성일
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1526-632x
Source
https://n.neurology.org/content/100/4/e408.long
DOI
10.1212/WNL.0000000000201426
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44732
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
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