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Nogueira, R.G.; Qureshi, M.M.; Abdalkader, M.; Martins, S.O.; Yamagami, H.; Qiu, Z.M.; ... ; SVIN COVID-19 Global Stroke Regi (2021)

Global impact of COVID-19 on stroke care and IV thrombolysis

Article / Letter to editor
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...Show moreObjective 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.Show less
All authors
Nogueira, R.G.; Qureshi, M.M.; Abdalkader, M.; Martins, S.O.; Yamagami, H.; Qiu, Z.M.; Mansour, O.Y.; Sathya, A.; Czlonkowska, A.; Tsivgoulis, G.; Sousa, D.A. de; Demeestere, J.; Mikulik, R.; Vanacker, P.; Siegler, J.E.; Korv, J.; Biller, J.; Liang, C.W.; Sangha, N.S.; Zha, A.M.; Czap, A.L.; Holmstedt, C.A.; Turan, T.N.; Ntaios, G.; Malhotra, K.; Tayal, A.; Loochtan, A.; Ranta, A.; Mistry, E.A.; Alexandrov, A.W.; Huang, D.Y.; Yaghi, S.; Raz, E.; Sheth, S.A.; Mohammaden, M.H.; Frankel, M.; Lamou, E.G.B.; Aref, H.M.; Elbassiouny, A.; Hassan, F.; Menecie, T.; Mustafa, W.; Shokri, H.M.; Roushdy, T.; Sarfo, F.S.; Alabi, T.O.; Arabambi, B.; Nwazor, E.O.; Sunmonu, T.A.; Wahab, K.; Yaria, J.; Mohammed, H.H.; Adebayo, P.B.; Riahi, A.D.; Sassi, S. ben; SVIN COVID-19 Global Stroke Regi
Date
2021-06-08
Journal
Neurology
Volume
96
Issue
23
Pages
E2824 - E2838
DOI
doi:10.1212/WNL.0000000000011885
Link
https://n.neurology.org/content/neurology/96/23/e2824.full.pdf