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 ... show 10 more
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Authors
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
Santiago, Igor Bessa
Lameirinhas da Silva, Isabelle
Sakelarova, Teodora
Kalpachki, Rosen
Alexiev, Filip
Catanese, Luciana
Cora, Elena Adela
Goyal, Mayank
Hill, Michael D
Kelly, Michael E
Khosravani, Houman
Lavoie, Pascale
Peeling, Lissa
Pikula, Aleksandra
Rivera, Rodrigo
Chen, Hui-Sheng
Chen, Yimin
Huo, Xiaochuan
Miao, Zhongrong
Yang, Shuiquan
Bedekovic, Marina Roje
Bralic, Marina
Budincevic, Hrvoje
Corredor-Quintero, Angel Basilio
Lara-Sarabia, Osvaldo E
Cabal, Martin
Tenora, Dusan
Fibrich, Petr
Herzig, Roman
Hlaváčová, Helena
Hrabanovska, Emanuela
Hlinovsky, David
Jurak, Lubomir
Kadlcikova, Jana
Karpowicz, Igor
Klecka, Lukas
Kovar, Martin
Lauer, David
Neumann, Jiri
Palouskova, Hana
Reiser, Martin
Rekova, Petra
Rohan, Vladimir
Skoda, Ondrej
Škorňa, Miroslav
Sobotková, Lenka
Sramek, Martin
Zakova, Lenka
Christensen, Hanne
Drenck, Nicolas
Iversen, Helle Klingenberg
Truelsen, Thomas Clement
Wienecke, Troels
Sobh, Khalid
Ylikotila, Pauli
Alpay, Kemal
Strbian, Daniel
Bernady, Patricia
Casenave, Philippe
Dan, Maria
Faucheux, Jean-Marc
Gentric, Jean-Christophe
Magro, Elsa
Sabben, Candice
Reiner, Peggy
Rouanet, Francois
Bohmann, Ferdinand O
Boskamp, Stefan
Mbroh, Joshua
Nagel, Simon
Nolte, Christian
Ringleb, Peter A
Rosenkranz, Michael
Poli, Sven
Thomalla, Götz
Karapanayiotides, Theodoros
Koutroulou, Ioanna
Kargiotis, Odysseas
Palaiodimou, Lina
Barrientos Guerra, Jose Dominguo
Huded, Vikram
Menon, Bindu
Nagendra, Shashank
Prajapati, Chintan
Sylaja, P N
Krishna Pramana, Nyoman Angga
Sani, Achmad Firdaus
Ghoreishi, Abdoreza
Farhoudi, Mehdi
Hokmabadi, Elyar Sadeghi
Raya, Tariq Abu
Kalmanovich, Shani Avnery
Ronen, Levite
Sabetay, Sergiu Ionut
Acampa, Maurizio
Adami, Alessandro
Castellan, Lucio
Longoni, Marco
Ornello, Raffaele
Renieri, Leonardo
Bigliani, Claudia Rolla
Romoli, Michele
Sacco, Simona
Salmaggi, Andrea
Sangalli, Davide
Zini, Andrea
Doijiri, Ryosuke
Fukuda, Hiroki
Fujinaka, Toshiyuki
Fujita, Kyohei
Imamura, Hirotoshi
Sakai, Nobuyuki
Kanamaru, Takuya
Kimura, Naoto
Kono, Ryuhei
Miyake, Kosuke
Sakaguchi, Manabu
Sakai, Kenichiro
Sonoda, Kazutaka
Todo, Kenichi
Miyashita, Fumio
Tokuda, Naoki
Matsumaru, Yuji
Matsumoto, Shoji
Ohara, Nobuyuki
Shindo, Seigo
Takenobu, Yohei
Yoshimoto, Takeshi
Toyoda, Kazunori
Uwatoko, Takeshi
Yagita, Yoshiki
Yamada, Takehiro
Yamamoto, Nobuaki
Yamamoto, Ryoo
Yazawa, Yukako
Sugiura, Yuri
Waweru, Peter Kuria
Baek, Jang-Hyun
Lee, Si Baek
Seo, Kwon-Duk
Sohn, Sung-Il
Arsovska, Anita Ante
Chan, Yong Chieh
Wan Zaidi, Wan Asyraf
Jaafar, Ainul Syahrilfazli
Gongora-Rivera, Fernando
Martinez-Marino, Manuel
Infante-Valenzuela, Adrian
Groppa, Stanislav
Leahu, Pavel
Coutinho, Jonathan M
Rinkel, Leon A
Dippel, Diederik W J
van Dam-Nolen, Dianne H K
Ranta, Annemarei
Wu, Teddy Y
Adebayo, Tajudeen Temitayo
Bello, Abiodun H
Nwazor, Ernest Okwundu
Sunmonu, Taofiki Ajao
Wahab, Kolawole Wasiu
Ronning, Ole Morten
Sandset, Else Charlotte
Al Hashimi, Amal M
Ahmad, Saima
Rashid, Umair
Rodriguez-Kadota, Liliana
Vences, Miguel Ángel
Yalung, Patrick Matic
Hao Dy, Jon Stewart
Pineda-Franks, Maria Carissa
Co, Christian Oliver
Brola, Waldemar
Debiec, Aleksander
Dorobek, Malgorzata
Karlinski, Michal Adam
Labuz-Roszak, Beata M
Lasek-Bal, Anetta
Sienkiewicz-Jarosz, Halina
Staszewski, Jacek
Sobolewski, Piotr
Wiacek, Marcin
Zielinska-Turek, Justyna
Araujo, Andre Pinho
Rocha, Mariana
Castro, Pedro
Cruz, Vitor Tedim
Ferreira, Paulo Venancio
Ferreira, Patricia
Nunes, Ana Paiva
Fonseca, Luisa
Marto, João Pedro
Pinho E Melo, Teresa
Rodrigues, Miguel
Silva, M Luis
Dimitriade, Adela
Falup-Pecurariu, Cristian
Hamid, May Adel
Venketasubramanian, Narayanaswamy
Krastev, Georgi
Mako, Miroslav
Ayo-Martin, Oscar
Hernández-Fernández, Francisco
Blasco, Jordi
Rodríguez-Vázquez, Alejandro
Cruz-Culebras, Antonio
Moniche, Francisco
Montaner, Joan
Perez-Sanchez, Soledad
García Sánchez, María Jesús
Rodríguez, Marta Guillán
Jood, Katarina
Nordanstig, Annika
Mazya, Michael V
Moreira, Tiago T P
Bernava, Gianmarco
Beyeler, Morin
Bolognese, Manuel
Carrera, Emmanuel
Dobrocky, Tomas
Karwacki, Grzegorz Marek
Keller, Emanuela
Hsieh, Chang Yang
Boonyakarnkul, Surawan
Churojana, Anchalee
Aykac, Ozlem
Ozdemir, Atilla
Bajrami, Arsida
Senadim, Songul
Hussain, Syed Irteza
John, Seby
Banerjee, Soma
Kwan, Joseph
Krishnan, Kailash
Lenthall, Robert
Matthews, Ashok
Wong, Ken
Zhang, Liqun
Altschul, Dorothea
Asif, Kaiz S
Bahiru, Zeelalem
Below, Kristine
Biller, José
Ruland, Sean
Chaudry, Saqib A
Chen, Michael
Chebl, Alex
Cibulka, Jackie
Cistrunk, Leon
Clark, Judith
Colasurdo, Marco
Czap, Alexandra
de Havenon, Adam
D'Amato, Salvatore
Dharmadhikari, Sushrut
Grimmett, Kasey B
Dmytriw, Adam A
Etherton, Mark R
Ezepue, Chizoba
Farooqui, Mudassir
Feske, Steven K
Fink, Lauren
Gasimova, Ulviyya
Guzik, Amy K
Hakemi, Maryam
Hovingh, Majesta
Khan, Muhib
Jillela, Dinesh
Kan, Peter T
Khatri, Rakesh
Khawaja, Ayaz M
Khoury, Naim N
Kiley, Nicole L
Kim, Benny S
Kolikonda, Murali K
Kuhn, Anna Luisa
Lara, Stephanie
Linares, Guillermo
Linfante, Italo
Lukovits, Timothy G
Lycan, Sarah
Male, Shailesh S
Maali, Laith
Mancin, John
Masoud, Hesham
Mohamed, Ghada A
Monteiro, Andre
Nahab, Fadi
Nalleballe, Krishna
Gutierrez, Santiago Ortega
Puri, Ajit S
Radaideh, Yazan
Rahangdale, Rahul H
Rai, Ansaar
Ramakrishnan, Pankajavalli
Reddy, Aravind B
Rojas-Soto, Diana M
Romero, Jose Rafael
Rost, Natalia S
Rothstein, Aaron
Omran, Setareh Salehi
Sheth, Sunil A
Siddiqui, Adnan H
Starosciak, Amy K
Tarlov, Nicholas E
Taylor, Robert A
Wang, Michael J
Wolfe, Jared
Wong, Ka-Ho
Le, Huynh Vu
Nguyen, Quy Viet
Pham, Thong Nhu
Nguyen, Trung Thanh
Phan, Hoang Thi
Ton, Mai Duy
Fischer, Urs
Michel, Patrik
Strambo, Davide
Martins, Sheila O
Zaidat, Osama O
Nogueira, Raul G
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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.
Source
Nguyen TN, Qureshi MM, Klein P, Yamagami H, Mikulik R, Czlonkowska A, Abdalkader M, Sedova P, Sathya A, Lo HC, Mansour OY, Vanguru HR, Lesaine E, Tsivgoulis G, Loochtan AI, Demeestere J, Uchino K, Inoa V, Goyal N, Charidimou A, Siegler JE, Yaghi S, Aguiar de Sousa D, Mohammaden M, Haussen DC, Kristoffersen ES, Lereis VP, Scollo SD, Campbell BCV, Ma A, Thomas JO, Parsons MW, Singhal S, Slater LA, Martins RT, Enzinger C, Gattringer T, Rahman A, Bonnet T, Ligot N, De Raedt S, Lemmens R, Vanacker P, Vandervorst F, Conforto AB, Hidalgo RCT, de Oliveira Neves L, Martins RT, Mora Cuervo DL, Rebello LC, Santiago IB, Lameirinhas da Silva I, Sakelarova T, Kalpachki R, Alexiev F, Catanese L, Cora EA, Goyal M, Hill MD, Kelly ME, Khosravani H, Lavoie P, Peeling L, Pikula A, Rivera R, Chen HS, Chen Y, Huo X, Miao Z, Yang S, Bedekovic MR, Bralic M, Budincevic H, Corredor-Quintero AB, Lara-Sarabia OE, Cabal M, Tenora D, Fibrich P, Herzig R, Hlaváčová H, Hrabanovska E, Hlinovsky D, Jurak L, Kadlcikova J, Karpowicz I, Klecka L, Kovar M, Lauer D, Neumann J, Palouskova H, Reiser M, Rekova P, Rohan V, Skoda O, Škorňa M, Sobotková L, Sramek M, Zakova L, Christensen H, Drenck N, Iversen HK, Truelsen TC, Wienecke T, Sobh K, Ylikotila P, Alpay K, Strbian D, Bernady P, Casenave P, Dan M, Faucheux JM, Gentric JC, Magro E, Sabben C, Reiner P, Rouanet F, Bohmann FO, Boskamp S, Mbroh J, Nagel S, Nolte C, Ringleb PA, Rosenkranz M, Poli S, Thomalla G, Karapanayiotides T, Koutroulou I, Kargiotis O, Palaiodimou L, Barrientos Guerra JD, Huded V, Menon B, Nagendra S, Prajapati C, Sylaja PN, Krishna Pramana NA, Sani AF, Ghoreishi A, Farhoudi M, Hokmabadi ES, Raya TA, Kalmanovich SA, Ronen L, Sabetay SI, Acampa M, Adami A, Castellan L, Longoni M, Ornello R, Renieri L, Bigliani CR, Romoli M, Sacco S, Salmaggi A, Sangalli D, Zini A, Doijiri R, Fukuda H, Fujinaka T, Fujita K, Imamura H, Sakai N, Kanamaru T, Kimura N, Kono R, Miyake K, Sakaguchi M, Sakai K, Sonoda K, Todo K, Miyashita F, Tokuda N, Matsumaru Y, Matsumoto S, Ohara N, Shindo S, Takenobu Y, Yoshimoto T, Toyoda K, Uwatoko T, Yagita Y, Yamada T, Yamamoto N, Yamamoto R, Yazawa Y, Sugiura Y, Waweru PK, Baek JH, Lee SB, Seo KD, Sohn SI, Arsovska AA, Chan YC, Wan Zaidi WA, Jaafar AS, Gongora-Rivera F, Martinez-Marino M, Infante-Valenzuela A, Groppa S, Leahu P, Coutinho JM, Rinkel LA, Dippel DWJ, van Dam-Nolen DHK, Ranta A, Wu TY, Adebayo TT, Bello AH, Nwazor EO, Sunmonu TA, Wahab KW, Ronning OM, Sandset EC, Al Hashimi AM, Ahmad S, Rashid U, Rodriguez-Kadota L, Vences MÁ, Yalung PM, Hao Dy JS, Pineda-Franks MC, Co CO, Brola W, Debiec A, Dorobek M, Karlinski MA, Labuz-Roszak BM, Lasek-Bal A, Sienkiewicz-Jarosz H, Staszewski J, Sobolewski P, Wiacek M, Zielinska-Turek J, Araujo AP, Rocha M, Castro P, Cruz VT, Ferreira PV, Ferreira P, Nunes AP, Fonseca L, Marto JP, Pinho E Melo T, Rodrigues M, Silva ML, Dimitriade A, Falup-Pecurariu C, Hamid MA, Venketasubramanian N, Krastev G, Mako M, Ayo-Martin O, Hernández-Fernández F, Blasco J, Rodríguez-Vázquez A, Cruz-Culebras A, Moniche F, Montaner J, Perez-Sanchez S, García Sánchez MJ, Rodríguez MG, Jood K, Nordanstig A, Mazya MV, Moreira TTP, Bernava G, Beyeler M, Bolognese M, Carrera E, Dobrocky T, Karwacki GM, Keller E, Hsieh CY, Boonyakarnkul S, Churojana A, Aykac O, Ozdemir A, Bajrami A, Senadim S, Hussain SI, John S, Banerjee S, Kwan J, Krishnan K, Lenthall R, Matthews A, Wong K, Zhang L, Altschul D, Asif KS, Bahiru Z, Below K, Biller J, Ruland S, Chaudry SA, Chen M, Chebl A, Cibulka J, Cistrunk L, Clark J, Colasurdo M, Czap A, de Havenon A, D'Amato S, Dharmadhikari S, Grimmett KB, Dmytriw AA, Etherton MR, Ezepue C, Farooqui M, Feske SK, Fink L, Gasimova U, Guzik AK, Hakemi M, Hovingh M, Khan M, Jillela D, Kan PT, Khatri R, Khawaja AM, Khoury NN, Kiley NL, Kim BS, Kolikonda MK, Kuhn AL, Lara S, Linares G, Linfante I, Lukovits TG, Lycan S, Male SS, Maali L, Mancin J, Masoud H, Mohamed GA, Monteiro A, Nahab F, Nalleballe K, Gutierrez SO, Puri AS, Radaideh Y, Rahangdale RH, Rai A, Ramakrishnan P, Reddy AB, Rojas-Soto DM, Romero JR, Rost NS, Rothstein A, Omran SS, Sheth SA, Siddiqui AH, Starosciak AK, Tarlov NE, Taylor RA, Wang MJ, Wolfe J, Wong KH, Le HV, Nguyen QV, Pham TN, Nguyen TT, Phan HT, Ton MD, Fischer U, Michel P, Strambo D, Martins SO, Zaidat OO, Nogueira RG. Global Impact of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events: One-Year Follow-up. Neurology. 2022 Oct 18:10.1212/WNL.0000000000201426. doi: 10.1212/WNL.0000000000201426. Epub ahead of print. PMID: 36257718.