Thanh N. NguyenDiogo C. HaussenMuhammad M. QureshiHiroshi YamagamiToshiyuki FujinakaOssama Y. MansourMohamad AbdalkaderMichael FrankelZhongming QiuAllan TaylorPedro LylykOmer F. EkerLaura MechtouffMichel PiotinFabricio Oliveira LimaFrancisco Mont'AlverneWazim IzzathNobuyuki SakaiMahmoud MohammadenAlhamza R. Al-BayatiLeonardo RenieriSalvatore MangiaficoDavid OzreticVanessa ChalumeauSaima AhmadUmair RashidSyed Irteza HussainSeby JohnEmma GriffinJohn ThorntonJose Antonio FiorotRodrigo RiveraNadia HammamiAnna M. Cervantes-ArslanianHormuzdiyar H. DasenbrockHuynh Le VuViet Quy NguyenSteven HettsRomain BourcierRomain GuileMelanie WalkerMalveeka SharmaDon FreiPascal JabbourNabeel HerialFawaz Al-MuftiAtilla Ozcan OzdemirOzlem AykacDheeraj GandhiChandril ChughCharles MatoukPascale LavoieRandall EdgellAndre Beer-FurlanMichael ChenMonika Killer-OberpfalzerVitor Mendes PereiraPatrick NicholsonVikram HudedNobuyuki OharaDaisuke WatanabeDong Hun ShinPedro S.C. MagalhaesRaghid KikanoSantiago Ortega-GutierrezMudassir FarooquiAmal Abou-HamdenTatsuo AmanoRyoo YamamotoAdrienne WeeksElena A. CoraRotem Sivan-HoffmannRoberto CrosaMarkus MöhlenbruchSimon NagelHosam Al-JehaniSunil A. ShethVictor S.Lopez RiveraJames E. SieglerAchmad Fidaus SaniAjit S. PuriAnna Luisa KuhnGianmarco BernavaPaolo MachiDaniel G. AbudOctavio M. Pontes-NetoAjay K. WakhlooBarbara VoetschEytan RazShadi YaghiBrijesh P. MehtaNaoto KimuraMamoru MurakamiJin Soo LeeJi Man HongRobert FahedGregory WalkerEiji HagashiSteve M. CordinaHong Gee RohAjou University HospitalGachon UniversityCleveland Clinic Abu DhabiKobe City Medical Center General HospitalImam Abdulrahman Bin Faisal universityMax Super Speciality Hospital, SaketCHU de Québec - Université LavalUniversitas AirlanggaHospital Geral de Rio de JaneiroUniversité de Tunis El Manar, Institut National de NeurologieAlexandria UniversityThomas Jefferson University HospitalKBC ZagrebNational Hospital Organization Osaka National HospitalRoyal Adelaide HospitalFondation Adolphe de RothschildUniversity of OttawaUniversity of Washington School of MedicineUniversity of Texas Health Science Center at HoustonWestchester Medical CenterSwedish Medical Center, ColoradoNottingham University Hospitals NHS TrustNYU Grossman School of MedicineUniversity of California, San FranciscoRambam Health Care Campus IsraelAzienda Ospedaliera CareggiKyorin UniversityRush University Medical CenterYale School of MedicineCooper University HospitalUniversity of TorontoDalhousie UniversityParacelsus Medizinische PrivatuniversitatHopital de BicetreUniversity of Maryland School of MedicineCHU de LyonHôpitaux Universitaires de GenèveUniversidade de São PauloUniversity of Iowa Hospitals &amp; ClinicsBoston University School of MedicineJapanese Red Cross Kyoto Daini HospitalBoston Medical CenterUniversitätsklinikum HeidelbergHopital G. et R. Laennec CHU de NantesEmory University School of MedicineUniversity of Massachusetts Chan Medical SchoolSt. Louis University School of MedicineBeaumont HospitalUniversity of South AlabamaUniversity of Cape TownKonkuk UniversityMemorial Neuroscience InstituteLau Medical CenterHue Central HospitalHospital Estadual Central de VitóriaYokohama Brain and Spine CenterNH Mazumdar Shah Medical CenterUniversidad de Eskişehir OsmangaziCentro Endovascular NeurológicoIMS Tokyo Katsushika General HospitalSaga-Ken Medical Centre KoseikanLahey HealthHospital Municipal São JoséLahore General HospitalClínica La Sagrada FamiliaInstituto de Neurocirugía Dr. AsenjoXinqiao HospitalIwate Prefectural Central Hospital2022-08-042022-08-042021-12-01Stroke and Vascular Neurology. Vol.6, No.4 (2021), 542-55220598696205986882-s2.0-85103441210https://repository.li.mahidol.ac.th/handle/20.500.14594/77610Background During the COVID-19 pandemic, decreased volumes of stroke admissions and mechanical thrombectomy were reported. The study's objective was to examine whether subarachnoid haemorrhage (SAH) hospitalisations and ruptured aneurysm coiling interventions demonstrated similar declines. Methods We conducted a cross-sectional, retrospective, observational study across 6 continents, 37 countries and 140 comprehensive stroke centres. Patients with the diagnosis of SAH, aneurysmal SAH, ruptured aneurysm coiling interventions and COVID-19 were identified by prospective aneurysm databases or by International Classification of Diseases, 10th Revision, codes. The 3-month cumulative volume, monthly volumes for SAH hospitalisations and ruptured aneurysm coiling procedures were compared for the period before (1 year and immediately before) and during the pandemic, defined as 1 March-31 May 2020. The prior 1-year control period (1 March-31 May 2019) was obtained to account for seasonal variation. Findings There was a significant decline in SAH hospitalisations, with 2044 admissions in the 3 months immediately before and 1585 admissions during the pandemic, representing a relative decline of 22.5% (95% CI -24.3% to -20.7%, p<0.0001). Embolisation of ruptured aneurysms declined with 1170-1035 procedures, respectively, representing an 11.5% (95%CI -13.5% to -9.8%, p=0.002) relative drop. Subgroup analysis was noted for aneurysmal SAH hospitalisation decline from 834 to 626 hospitalisations, a 24.9% relative decline (95% CI -28.0% to -22.1%, p<0.0001). A relative increase in ruptured aneurysm coiling was noted in low coiling volume hospitals of 41.1% (95% CI 32.3% to 50.6%, p=0.008) despite a decrease in SAH admissions in this tertile. Interpretation There was a relative decrease in the volume of SAH hospitalisations, aneurysmal SAH hospitalisations and ruptured aneurysm embolisations during the COVID-19 pandemic. These findings in SAH are consistent with a decrease in other emergencies, such as stroke and myocardial infarction.Mahidol UniversityMedicineArticleSCOPUS10.1136/svn-2020-000695