Global Impact of COVID-19 on Stroke Care and IV Thrombolysis
Raul G. Nogueira, Muhammad M. Qureshi, Mohamad Abdalkader, Sheila Cristina Ouriques Martins, Hiroshi Yamagami, Zhongming Qiu, Ossama Yassin Mansour, Anvitha Sathya, Anna Członkowska, Georgios Tsivgoulis, Diana Aguiar de Sousa, Jelle Demeestere, Robert Mikulík, Peter Vanacker, James E. Siegler, Janika Kõrv, José Biller, Conrad W Liang, Navdeep Sangha, Alicia Zha, Alexandra L. Czap, Christine A Holmstedt, Tanya N. Turan, George Ntaios, Konark Malhotra, Ashis Tayal, Aaron Loochtan, Annemarei Ranta, Eva Mistry, Anne W. Alexandrov, David Huang, Shadi Yaghi, Eytan Raz, Sunil A. Sheth, Mahmoud Mohammaden, Michael Frankel, Eric Guemekane Bila Lamou, Hany Aref, Ahmed Elbassiouny, Farouk Hassan, Tarek Menecie, Wessam Mustafa, Hossam Shokri, Tamer Roushdy, Fred Stephen Sarfo, Tolulope Oyetunde Alabi, Babawale Arabambi, Ernest Nwazor, Taofiki Sunmonu, Kolawole Wahab, Joseph Yaria, Haytham Hussein Mohammed, Philip Adebayo, A. Riahi, Samia Ben Sassi, Lenon Gwaunza, Gift Ngwende, David Sahakyan, Aminur Rahman, Zhibing Ai, Fanghui Bai, Zhenhui Duan, Yonggang Hao, Wenguo Huang, Guangwen Li, Wei Li, Ganzhe Liu, Jun Luo, Xianjin Shang, Yi Sui, Ling Tian, Hongbin Wen, Bo Wu, Yuying Yan, Zhengzhou Yuan, Hao Zhang, Jun Zhang, Wenlong Zhao, Wenjie Zi, Thomas Leung, Chandril Chugh, Vikram Huded, Bindu Menon, Jeyaraj Pandian, PN Sylaja, Fritz Sumantri Usman, Mehdi Farhoudi, Elyar Sadeghi‐Hokmabadi, Anat Horev, Anna Reznik, Rotem Sivan Hoffmann, Nobuyuki Ohara, Nobuyuki Sakai, Daisuke Watanabe, Ryoo Yamamoto, Ryosuke Doijiri, Naoki Tokuda, Takehiro Yamada, Tadashi Terasaki, Yukako Yazawa
Abstract
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: < 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.