EXPRESS: Global Impact of the COVID-19 Pandemic on Stroke Hospitalizations and Mechanical Thrombectomy Volumes.
Raul G. Nogueira, Mohamad Abdalkader, Muhammed M. Qureshi, M Frankel, Mansour, Ossama Yassin, Hiroshi Yamagami, Zhongming Qiu, Mehdi Farhoudi, James E. Siegler, Shadi Yaghi, Eytan Raz, Nobuyuki Sakai, Nobuyuki Ohara, Michel Piotin, Laura Mechtouff, Omer Eker, Vanessa Chalumeau, Timothy Kleinig, Jianmin Liu, Raoul Pop, Hugh Stephen Winters, Xianjin Shang, Alejandro Rodríguez Vásquez, Jordi Blasco, Juan F. Arenillas, Mario Martínez‐Galdámez, Alex Brehm, Marios Psychogios, Pedro Lylyk, Diogo C Haussen, Alhamza R Al‐Bayati, Mahmoud Mohammaden, Luísa Fonseca, Maria Luà S Silva, Francisco Mont’Alverne, Fabrício Oliveira Lima, Leonardo Renieri, Salvatore Mangiafico, Urs Fischer, Jan Gralla, Donald Frei, Chandril Chugh, Brijesh Mehta, Simon Nagel, Markus Mã Hlenbruch, Santiago Ortega‐Gutiérrez, Mudassir Farooqui, Ameer E Hassan, Allan Taylor, Bertrand Lapergue, Arturo Consoli, Bruce Campbell, Malveeka Sharma, Melanie Walker, Noel van Horn, Jens Fiehler, Huy Thang Nguyen, Nguyen, Quoc Trung, Daisuke Watanabe, Hao Zhang, Huynh Vu Le, Viet Q. Nguyen, Ruchir Shah, Thomas Devlin, Priyank Khandelwal, Italo Linfante, Wazim Izzath, Pablo M. Lavados, Veronica Olavarrà A, Gisele Sampaio Silva, Anna Verena de Carvalho Sousa, Jawad F. Kirmani, Martin Bendszus, Tatsuo Amano, Ryoo Yamamoto, Ryosuke Doijiri, Naoki Tokuda, Takehiro Yamada, Tadashi Terasaki, Yukako Yazawa, Jane G. Morris, Emma Griffin, John Thornton, Pascale Lavoie, Charles Matouk, Michael D. Hill, Andrew M. Demchuk, Monika Killer‐Oberpfalzer, Fadi Nahab, Dorothea Altschul, Natàlia Pérez de la Ossa, Raghid Kikano, William Boisseau, Gregory Walker, Steve M Cordina, Ajit S Puri, Anna Kristina Kuhn, Dheeraj Gandhi, Thanh N. Nguyen
Abstract
BACKGROUND The COVID-19 pandemic led to profound changes in the organization of health care systems worldwide. AIMS We sought to measure the global impact of the COVID-19 pandemic on the volumes for mechanical thrombectomy (MT), stroke, and intracranial hemorrhage (ICH) hospitalizations over a 3-month period at the height of the pandemic (March 1 to May 31, 2020) compared with two control 3-month periods (immediately preceding and one year prior). METHODS Retrospective, observational, international study, across 6 continents, 40 countries, and 187 comprehensive stroke centers. The diagnoses were identified by their ICD-10 codes and/or classifications in stroke databases at participating centers. RESULTS The hospitalization volumes for any stroke, ICH, and MT were 26,699, 4,002, and 5,191 in the 3 months immediately before versus 21,576, 3,540, and 4,533 during the first 3 pandemic months, representing declines of 19.2% (95%CI,-19.7 to -18.7), 11.5% (95%CI,-12.6 to -10.6), and 12.7% (95%CI,-13.6 to -11.8), respectively. The decreases were noted across centers with high, mid, and low COVID-19 hospitalization burden, and also across high, mid, and low volume stroke/MT centers. High-volume COVID-19 centers (-20.5%) had greater declines in MT volumes than mid- (-10.1%) and low-volume (-8.7%) centers (p<0.0001). There was a 1.5% stroke rate across 54,366 COVID-19 hospitalizations. SARS-CoV-2 infection was noted in 3.9% (784/20,250) of all stroke admissions. CONCLUSION The COVID-19 pandemic was associated with a global decline in the volume of overall stroke hospitalizations, MT procedures, and ICH admission volumes. Despite geographic variations, these volume reductions were observed regardless of COVID-19 hospitalization burden and pre-pandemic stroke/MT volumes.