TY - JOUR

T1 - Global Impact of COVID-19 on Stroke Care and IV Thrombolysis

AU - Nogueira, Raul G.

AU - Qureshi, Muhammad M.

AU - Abdalkader, Mohamad

AU - Martins, Sheila Ouriques

AU - Yamagami, Hiroshi

AU - Qiu, Zhongming

AU - Mansour, Ossama Yassin

AU - Sathya, Anvitha

AU - Czlonkowska, Anna

AU - Tsivgoulis, Georgios

AU - Aguiar de Sousa, Diana

AU - Demeestere, Jelle

AU - Mikulik, Robert

AU - Vanacker, Peter

AU - Siegler, James E.

AU - Kõrv, Janika

AU - Biller, Jose

AU - Liang, Conrad W.

AU - Sangha, Navdeep S.

AU - Zha, Alicia M.

AU - Czap, Alexandra L.

AU - Holmstedt, Christine Anne

AU - Turan, Tanya N.

AU - Ntaios, George

AU - Malhotra, Konark

AU - Tayal, Ashis

AU - Loochtan, Aaron

AU - Ranta, Annamarei

AU - Mistry, Eva A.

AU - Alexandrov, Anne W.

AU - Huang, David Y.

AU - Yaghi, Shadi

AU - Raz, Eytan

AU - Sheth, Sunil A.

AU - Mohammaden, Mahmoud H.

AU - Frankel, Michael

AU - Bila Lamou, Eric Guemekane

AU - Aref, Hany M.

AU - Elbassiouny, Ahmed

AU - Hassan, Farouk

AU - Menecie, Tarek

AU - Mustafa, Wessam

AU - Shokri, Hossam M.

AU - Roushdy, Tamer

AU - Sarfo, Fred S.

AU - Alabi, Tolulope Oyetunde

AU - Krarup Christensen, Hanne

AU - Klingenberg Iversen, Helle

AU - Truelsen, Thomas Clement

AU - Wienecke, Troels

AU - SVIN COVID-19 Global Stroke Registry

AU - SVIN COVID-19 Global Stroke Registry

N1 - Publisher Copyright: © 2021 American Academy of Neurology.

PY - 2021/6/8

Y1 - 2021/6/8

N2 - OBJECTIVE: To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods. METHODS: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. RESULTS: There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95% confidence interval [CI] -11.7 to -11.3, p < 0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95% CI -13.8 to -12.7, p < 0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95% CI -13.7 to -10.3, p = 0.001). Recovery of stroke hospitalization volume (9.5%, 95% CI 9.2-9.8, p < 0.0001) was noted over the 2 later (May, June) vs the 2 earlier (March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was noted in 3.3% (1,722/52,026) of all stroke admissions. CONCLUSIONS: The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID-19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months.

AB - OBJECTIVE: To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods. METHODS: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. RESULTS: There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95% confidence interval [CI] -11.7 to -11.3, p < 0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95% CI -13.8 to -12.7, p < 0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95% CI -13.7 to -10.3, p = 0.001). Recovery of stroke hospitalization volume (9.5%, 95% CI 9.2-9.8, p < 0.0001) was noted over the 2 later (May, June) vs the 2 earlier (March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was noted in 3.3% (1,722/52,026) of all stroke admissions. CONCLUSIONS: The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID-19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months.

U2 - 10.1212/WNL.0000000000011885

DO - 10.1212/WNL.0000000000011885

M3 - Comment/debate

C2 - 33766997

AN - SCOPUS:85106084873

VL - 96

SP - e2824-e2838

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 23

ER -