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    Global impact of the COVID-19 pandemic on subarachnoid haemorrhage hospitalisations, aneurysm treatment and in-hospital mortality: 1-year follow-up

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    Authors
    Nguyen, Thanh N.
    Kuhn, Anna Luisa
    Puri, Ajit S
    Nogueira, Raul G
    UMass Chan Affiliations
    Radiology
    Document Type
    Journal Article
    Publication Date
    2022-07-28
    Keywords
    CEREBROVASCULAR DISEASE
    COVID-19
    SUBARACHNOID HAEMORRHAGE
    
    Metadata
    Show full item record
    Link to Full Text
    https://doi.org/10.1136/jnnp-2022-329200
    Abstract
    Background: Prior studies indicated a decrease in the incidences of aneurysmal subarachnoid haemorrhage (aSAH) during the early stages of the COVID-19 pandemic. We evaluated differences in the incidence, severity of aSAH presentation, and ruptured aneurysm treatment modality during the first year of the COVID-19 pandemic compared with the preceding year. Methods: We conducted a cross-sectional study including 49 countries and 187 centres. We recorded volumes for COVID-19 hospitalisations, aSAH hospitalisations, Hunt-Hess grade, coiling, clipping and aSAH in-hospital mortality. Diagnoses were identified by International Classification of Diseases, 10th Revision, codes or stroke databases from January 2019 to May 2021. Results: Over the study period, there were 16 247 aSAH admissions, 344 491 COVID-19 admissions, 8300 ruptured aneurysm coiling and 4240 ruptured aneurysm clipping procedures. Declines were observed in aSAH admissions (-6.4% (95% CI -7.0% to -5.8%), p=0.0001) during the first year of the pandemic compared with the prior year, most pronounced in high-volume SAH and high-volume COVID-19 hospitals. There was a trend towards a decline in mild and moderate presentations of subarachnoid haemorrhage (SAH) (mild: -5% (95% CI -5.9% to -4.3%), p=0.06; moderate: -8.3% (95% CI -10.2% to -6.7%), p=0.06) but no difference in higher SAH severity. The ruptured aneurysm clipping rate remained unchanged (30.7% vs 31.2%, p=0.58), whereas ruptured aneurysm coiling increased (53.97% vs 56.5%, p=0.009). There was no difference in aSAH in-hospital mortality rate (19.1% vs 20.1%, p=0.12). Conclusion: During the first year of the pandemic, there was a decrease in aSAH admissions volume, driven by a decrease in mild to moderate presentation of aSAH. There was an increase in the ruptured aneurysm coiling rate but neither change in the ruptured aneurysm clipping rate nor change in aSAH in-hospital mortality. Trial registration number: NCT04934020.
    Source
    SVIN COVID-19 Global SAH Registry. Global impact of the COVID-19 pandemic on subarachnoid haemorrhage hospitalisations, aneurysm treatment and in-hospital mortality: 1-year follow-up. J Neurol Neurosurg Psychiatry. 2022 Jul 28:jnnp-2022-329200. doi: 10.1136/jnnp-2022-329200. Epub ahead of print. PMID: 35902229.
    DOI
    10.1136/jnnp-2022-329200
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/51534
    PubMed ID
    35902229
    Notes
    Anna Luisa Kuhn and Ajit S. Puri are collaborators in the SVIN COVID-19 Global SAH Registry. Full author list omitted for brevity. For the full list of authors, see article.
    Rights
    © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.
    ae974a485f413a2113503eed53cd6c53
    10.1136/jnnp-2022-329200
    Scopus Count
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    COVID-19 Publications by UMass Chan Authors
    Radiology Publications

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