Global Effect of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events A 1-Year Follow-up
Issued Date
2023-01-24
Resource Type
ISSN
00283878
eISSN
1526632X
Scopus ID
2-s2.0-85147770827
Pubmed ID
36257718
Journal Title
Neurology
Volume
100
Issue
4
Start Page
E408
End Page
E421
Rights Holder(s)
SCOPUS
Bibliographic Citation
Neurology Vol.100 No.4 (2023) , E408-E421
Suggested Citation
Nguyen T.N., Qureshi M.M., Klein P., Yamagami H., Mikulik R., Czlonkowska A., Abdalkader M., Sedova P., Sathya A., Lo H.C., Mansour O.Y., Vanguru H.R., Lesaine E., Tsivgoulis G., Loochtan A.I., Demeestere J., Uchino K., Inoa V., Goyal N., Charidimou A., Siegler J.E., Yaghi S., Aguiar de Sousa D., Mohammaden M.H., Haussen D.C., Kristoffersen E.S., Lereis V.P., Scollo S.D., Campbell B.C.V., Ma A., Thomas J.O., Parsons M.W., Singhal S., Slater L.A., Tomazini Martins R., Enzinger C., Gattringer T., Rahman A., Bonnet T., Ligot N., De Raedt S., Lemmens R., Vanacker P., Vandervorst F., Conforto A.B., Hidalgo R.C.T., de Oliveira Neves L., Martins R.T., Cuervo D.L.M., Rebello L.C., Santiago I.B., da Silva I.L., Sakelarova T., Kalpachki R., Alexiev F., Catanese L., Cora E.A., Goyal M., Hill M.D., Kelly M.E., Khosravani H., Lavoie P., Peeling L., Pikula A., Rivera R., Chen H.S., Chen Y., Huo X., Miao Z., Yang S., Bedekovic M.R., Bralic M., Budincevic H., Corredor-Quintero A.B., Lara-Sarabia O.E., 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., Skorna M., Sobotková L., Sramek M., Zakova L., Christensen H., Drenck N. Global Effect of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events A 1-Year Follow-up. Neurology Vol.100 No.4 (2023) , E408-E421. E421. doi:10.1212/WNL.0000000000201426 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/82454
Title
Global Effect of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events A 1-Year Follow-up
Author(s)
Nguyen T.N.
Qureshi M.M.
Klein P.
Yamagami H.
Mikulik R.
Czlonkowska A.
Abdalkader M.
Sedova P.
Sathya A.
Lo H.C.
Mansour O.Y.
Vanguru H.R.
Lesaine E.
Tsivgoulis G.
Loochtan A.I.
Demeestere J.
Uchino K.
Inoa V.
Goyal N.
Charidimou A.
Siegler J.E.
Yaghi S.
Aguiar de Sousa D.
Mohammaden M.H.
Haussen D.C.
Kristoffersen E.S.
Lereis V.P.
Scollo S.D.
Campbell B.C.V.
Ma A.
Thomas J.O.
Parsons M.W.
Singhal S.
Slater L.A.
Tomazini Martins R.
Enzinger C.
Gattringer T.
Rahman A.
Bonnet T.
Ligot N.
De Raedt S.
Lemmens R.
Vanacker P.
Vandervorst F.
Conforto A.B.
Hidalgo R.C.T.
de Oliveira Neves L.
Martins R.T.
Cuervo D.L.M.
Rebello L.C.
Santiago I.B.
da Silva I.L.
Sakelarova T.
Kalpachki R.
Alexiev F.
Catanese L.
Cora E.A.
Goyal M.
Hill M.D.
Kelly M.E.
Khosravani H.
Lavoie P.
Peeling L.
Pikula A.
Rivera R.
Chen H.S.
Chen Y.
Huo X.
Miao Z.
Yang S.
Bedekovic M.R.
Bralic M.
Budincevic H.
Corredor-Quintero A.B.
Lara-Sarabia O.E.
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.
Skorna M.
Sobotková L.
Sramek M.
Zakova L.
Christensen H.
Drenck N.
Qureshi M.M.
Klein P.
Yamagami H.
Mikulik R.
Czlonkowska A.
Abdalkader M.
Sedova P.
Sathya A.
Lo H.C.
Mansour O.Y.
Vanguru H.R.
Lesaine E.
Tsivgoulis G.
Loochtan A.I.
Demeestere J.
Uchino K.
Inoa V.
Goyal N.
Charidimou A.
Siegler J.E.
Yaghi S.
Aguiar de Sousa D.
Mohammaden M.H.
Haussen D.C.
Kristoffersen E.S.
Lereis V.P.
Scollo S.D.
Campbell B.C.V.
Ma A.
Thomas J.O.
Parsons M.W.
Singhal S.
Slater L.A.
Tomazini Martins R.
Enzinger C.
Gattringer T.
Rahman A.
Bonnet T.
Ligot N.
De Raedt S.
Lemmens R.
Vanacker P.
Vandervorst F.
Conforto A.B.
Hidalgo R.C.T.
de Oliveira Neves L.
Martins R.T.
Cuervo D.L.M.
Rebello L.C.
Santiago I.B.
da Silva I.L.
Sakelarova T.
Kalpachki R.
Alexiev F.
Catanese L.
Cora E.A.
Goyal M.
Hill M.D.
Kelly M.E.
Khosravani H.
Lavoie P.
Peeling L.
Pikula A.
Rivera R.
Chen H.S.
Chen Y.
Huo X.
Miao Z.
Yang S.
Bedekovic M.R.
Bralic M.
Budincevic H.
Corredor-Quintero A.B.
Lara-Sarabia O.E.
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.
Skorna M.
Sobotková L.
Sramek M.
Zakova L.
Christensen H.
Drenck N.
Author's Affiliation
Hotchkiss Brain Institute
Bordeaux Population Health Research Center (BPH)
Universidade de Lisboa
CHU de Québec - Université Laval
Klinički Bolnički Centar Rijeka
Shenyang General Hospital of PLA
Beijing Tiantan Hospital, Capital Medical University
Institute of Psychiatry and Neurology, Warszawa
Universitair Ziekenhuis Brussel
Hospital Nossa Senhora da Conceicao
Hospital Moinhos de Vento
Fakultní Nemocnice u Sv. Anny v Brně
Akershus University Hospital
Hôpital Erasme
Hospital de Base do Distrito Federal
Hospital de Base
Všeobecná Fakultní Nemocnice v Praze
Alexandria University
National Hospital Organization Osaka National Hospital
McMaster University
KU Leuven– University Hospital Leuven
Sunnybrook Health Sciences Centre
Mater Hospital Brisbane
University of Melbourne
Fundacion Para La Lucha Contra Las Enfermedades Neurologicas de La Infancia
General Hospital Sveti Duh
Universitat Graz
Fakultni Nemocnice Brno
Cleveland Clinic Foundation
Monash University
Royal University Hospital
Fakultní Nemocnice Hradec Králové
Sveučilište Josipa Jurja Strossmayera u Osijeku
Cooper University Hospital
Prague Central Military Hospital
University of Toronto
Dalhousie University
Attikon University Hospital
Copenhagen University Hospital
Universitair Ziekenhuis Antwerpen
Universiteit Antwerpen
University Hospital Alexandrovska
Brown University
Fakultní Nemocnice Královské Vinohrady
Na Homolce Hospital
Universitetet i Oslo
Universidade de São Paulo
Royal North Shore Hospital
Monash Medical Centre
Medizinische Universität Graz
Liverpool Hospital
Fakultní Nemocnice Plzeň
Sir Salimullah Medical College
Boston Medical Center
Emory University School of Medicine
Hospital J.M. Ramos Mejia, Buenos Aires
Uherskohradištská Hospital
Oblastni Nem-ocnice
Blansko Hospital
Foshan Sanshui District People's Hospital
Nemocnice Třinec
Clínica de la Costa
Hospital Vyskov
County Hospital Chomutov
Oblastní nemocnice Trutnov a. s.
University of Tennessee
Neurocenter
Thomayer University Hospital Prague
Hospital Pribram
Karvina Mining Hospital
Hospital Universitario San Juan de Dios
Sestre milosrdnice University Hospital Center
Regional Hospital Karlovy Vary
Centro Hospitalar Lisboa Central
Instituto de Neurocirugía Dr. Asenjo
Hospital São Carlos
Hospital Ceske Budejovice
Faculty Hospital
Hospital Jihlava
Bordeaux Population Health Research Center (BPH)
Universidade de Lisboa
CHU de Québec - Université Laval
Klinički Bolnički Centar Rijeka
Shenyang General Hospital of PLA
Beijing Tiantan Hospital, Capital Medical University
Institute of Psychiatry and Neurology, Warszawa
Universitair Ziekenhuis Brussel
Hospital Nossa Senhora da Conceicao
Hospital Moinhos de Vento
Fakultní Nemocnice u Sv. Anny v Brně
Akershus University Hospital
Hôpital Erasme
Hospital de Base do Distrito Federal
Hospital de Base
Všeobecná Fakultní Nemocnice v Praze
Alexandria University
National Hospital Organization Osaka National Hospital
McMaster University
KU Leuven– University Hospital Leuven
Sunnybrook Health Sciences Centre
Mater Hospital Brisbane
University of Melbourne
Fundacion Para La Lucha Contra Las Enfermedades Neurologicas de La Infancia
General Hospital Sveti Duh
Universitat Graz
Fakultni Nemocnice Brno
Cleveland Clinic Foundation
Monash University
Royal University Hospital
Fakultní Nemocnice Hradec Králové
Sveučilište Josipa Jurja Strossmayera u Osijeku
Cooper University Hospital
Prague Central Military Hospital
University of Toronto
Dalhousie University
Attikon University Hospital
Copenhagen University Hospital
Universitair Ziekenhuis Antwerpen
Universiteit Antwerpen
University Hospital Alexandrovska
Brown University
Fakultní Nemocnice Královské Vinohrady
Na Homolce Hospital
Universitetet i Oslo
Universidade de São Paulo
Royal North Shore Hospital
Monash Medical Centre
Medizinische Universität Graz
Liverpool Hospital
Fakultní Nemocnice Plzeň
Sir Salimullah Medical College
Boston Medical Center
Emory University School of Medicine
Hospital J.M. Ramos Mejia, Buenos Aires
Uherskohradištská Hospital
Oblastni Nem-ocnice
Blansko Hospital
Foshan Sanshui District People's Hospital
Nemocnice Třinec
Clínica de la Costa
Hospital Vyskov
County Hospital Chomutov
Oblastní nemocnice Trutnov a. s.
University of Tennessee
Neurocenter
Thomayer University Hospital Prague
Hospital Pribram
Karvina Mining Hospital
Hospital Universitario San Juan de Dios
Sestre milosrdnice University Hospital Center
Regional Hospital Karlovy Vary
Centro Hospitalar Lisboa Central
Instituto de Neurocirugía Dr. Asenjo
Hospital São Carlos
Hospital Ceske Budejovice
Faculty Hospital
Hospital Jihlava
Other Contributor(s)
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.