Abstract
BackgroundThe COVID-19 pandemic led to profound changes in the organization of health care systems worldwide.AimsWe sought to measure the global impact of the COVID-19 pandemic on the volumes for mechanical thrombectomy, stroke, and intracranial hemorrhage hospitalizations over a three-month period at the height of the pandemic (1 March–31 May 2020) compared with two control three-month periods (immediately preceding and one year prior).MethodsRetrospective, 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.ResultsThe hospitalization volumes for any stroke, intracranial hemorrhage, and mechanical thrombectomy were 26,699, 4002, and 5191 in the three months immediately before versus 21,576, 3540, and 4533 during the first three 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/mechanical thrombectomy centers. High-volume COVID-19 centers (−20.5%) had greater declines in mechanical thrombectomy 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.ConclusionThe COVID-19 pandemic was associated with a global decline in the volume of overall stroke hospitalizations, mechanical thrombectomy procedures, and intracranial hemorrhage admission volumes. Despite geographic variations, these volume reductions were observed regardless of COVID-19 hospitalization burden and pre-pandemic stroke/mechanical thrombectomy volumes.
Highlights
In December 2019, a novel highly pathogenic virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), caused an infectious disease involving multiple organ systems termed coronavirus disease 2019 (COVID-19)
The COVID-19 pandemic was associated with a global decline in the volume of overall stroke hospitalizations, mechanical thrombectomy procedures, and intracranial hemorrhage admission volumes
months in 2019 (MT) volume data was represented by 176 centers in the primary analysis with 5191 procedures in the three months immediately preceding compared to 4533 procedures during the first three months of the pandemic, representing a 12.7% (95%CI, À13.6 to À11.8) decline, Table 2
Summary
In December 2019, a novel highly pathogenic virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), caused an infectious disease involving multiple organ systems termed coronavirus disease 2019 (COVID-19). On 11 March 2020, the World Health Organization declared a global pandemic as COVID19 hospitalizations and emergency medical system activations increased. As a potential consequence of its neurotropism as well as the inflammatory, immunological, and coagulation disorders, COVID-19 has been reported in association with a broad array of neurological disorders including encephalitis, GuillainBarre syndrome, seizures, ischemic, and hemorrhagic strokes.[1] Some groups reported an increase in cryptogenic strokes involving young patients with SARS-CoV-2 infection, possibly in association with endothelial inflammation and thrombotic diathesis.[2,3,4,5,6,7] Others reported a decline in the rates of stroke hospitalizations and the proportion of patients receiving. The COVID-19 pandemic led to profound changes in the organization of health care systems worldwide
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
