Global Impact of COVID-19 on Stroke Care and IV Thrombolysis. (8th June 2021)

• Record Type: Journal Article
• Authors: Nogueira, Raul G.; Qureshi, Muhammad M.; Abdalkader, Mohamad; Martins, Sheila Ouriques; Yamagami, Hiroshi; Qiu, Zhongming; Mansour, Ossama Yassin; Sathya, Anvitha; Czlonkowska, Anna; Tsivgoulis, Georgios; Aguiar de Sousa, Diana; Demeestere, Jelle; Mikulik, Robert; Vanacker, Peter; Siegler, James E.; Kõrv, Janika; Biller, Jose; Liang, Conrad W.; Sangha, Navdeep S.; Zha, Alicia M.; Czap, Alexandra L.; Holmstedt, Christine Anne; Turan, Tanya N.; Ntaios, George; Malhotra, Konark; Tayal, Ashis; Loochtan, Aaron; Ranta, Annamarei; Mistry, Eva A.; Alexandrov, Anne W.; Huang, David Y.; Yaghi, Shadi; Raz, Eytan; Sheth, Sunil A.; Mohammaden, Mahmoud H.; Frankel, Michael; Bila Lamou, Eric Guemekane; Aref, Hany M.; Elbassiouny, Ahmed; Hassan, Farouk; Menecie, Tarek; Mustafa, Wessam; Shokri, Hossam M.; Roushdy, Tamer; Sarfo, Fred S.; Alabi, Tolulope Oyetunde; Arabambi, Babawale; Nwazor, Ernest O.; Sunmonu, Taofiki Ajao; Wahab, Kolawole; Yaria, Joseph; Mohammed, Haytham Hussein; Adebayo, Philip B.; Riahi, Anis D.; Sassi, Samia Ben; Gwaunza, Lenon; Ngwende, Gift Wilson; Sahakyan, David; Rahman, Aminur; Ai, Zhibing; Bai, Fanghui; Duan, Zhenhui; Hao, Yonggang; Huang, Wenguo; Li, Guangwen; Li, Wei; Liu, Ganzhe; Luo, Jun; Shang, Xianjin; Sui, Yi; Tian, Ling; Wen, Hongbin; Wu, Bo; Yan, Yuying; Yuan, Zhengzhou; Zhang, Hao; Zhang, Jun; Zhao, Wenlong; Zi, Wenjie; Leung, Thomas W.; Chugh, Chandril; Huded, Vikram; Menon, Bindu; Pandian, Jeyaraj Durai; Sylaja, PN; Usman, Fritz Sumantri; Farhoudi, Mehdi; Hokmabadi, Elyar Sadeghi; Horev, Anat; Reznik, Anna; Sivan Hoffmann, Rotem; Ohara, Nobuyuki; Sakai, Nobuyuki; Watanabe, Daisuke; Yamamoto, Ryoo; Doijiri, Ryosuke; Tokuda, Naoki; Yamada, Takehiro; Terasaki, Tadashi; Yazawa, Yukako; Uwatoko, Takeshi; Dembo, Tomohisa; Shimizu, Hisao; Sugiura, Yuri; Miyashita, Fumio; Fukuda, Hiroki; Miyake, Kosuke; Shimbo, Junsuke; Sugimura, Yusuke; Yagita, Yoshiki; Takenobu, Yohei; Matsumaru, Yuji; Yamada, Satoshi; Kono, Ryuhei; Kanamaru, Takuya; Yamazaki, Hidekazu; Sakaguchi, Manabu; Todo, Kenichi; Yamamoto, Nobuaki; Sonoda, Kazutaka; Yoshida, Tomoko; Hashimoto, Hiroyuki; Nakahara, Ichiro; Kondybayeva, Aida; Faizullina, Kamila; Kamenova, Saltanat; Zhanuzakov, Murat; Baek, Jang-Hyun; Hwang, Yangha; Lee, Jin Soo; Lee, Si Baek; Moon, Jusun; Park, Hyungjong; Seo, Jung Hwa; Seo, Kwon-Duk; Sohn, Sung Il; Young, Chang Jun; Ahdab, Rechdi; Wan Zaidi, Wan Asyraf; Aziz, Zariah Abdul; Basri, Hamidon bin; Chung, Law Wan; Ibrahim, Aznita Binti; Ibrahim, Khairul Azmi; Looi, Irene; Tan, Wee Yong; Yahya, Nafisah Wan; Groppa, Stanislav; Leahu, Pavel; Al Hashmi, Amal M.; Imam, Yahia Zakaria; Akhtar, Naveed; Pineda-Franks, Maria Carissa; Co, Christian Oliver; Kandyba, Dmitriy; Alhazzani, Adel; Al-Jehani, Hosam; Tham, Carol Huilian; Mamauag, Marlie Jane; Venketasubramanian, Narayanaswamy; Chen, Chih-Hao; Tang, Sung-Chun; Churojana, Anchalee; Akil, Esref; aykaç, özlem; Ozdemir, Atilla Ozcan; Giray, Semih; Hussain, Syed Irteza; John, Seby; Le Vu, Huynh; Tran, Anh Duc; Nguyen, Huy Hoang; Nhu Pham, Thong; Nguyen, Thang Huy; Nguyen, Trung Quoc; Gattringer, Thomas; Enzinger, Christian; Killer-Oberpfalzer, Monika; Bellante, Flavio; De Blauwe, Sofie; Vanhooren, Geert; De Raedt, Sylvie; Dusart, Anne; Lemmens, Robin; Ligot, Noemie; Pierre Rutgers, Matthieu; Yperzeele, Laetitia; Alexiev, Filip; Sakelarova, Teodora; Bedeković, Marina Roje; Budincevic, Hrvoje; Cindric, Igor; Hucika, Zlatko; Ozretic, David; Saric, Majda Seferovic; Pfeifer, František; Karpowic, Igor; Cernik, David; Sramek, Martin; Skoda, Miroslav; Hlavacova, Helena; Klecka, Lukas; Koutny, Martin; Vaclavik, Daniel; Skoda, Ondrej; Fiksa, Jan; Hanelova, Katerina; Nevsimalova, Miroslava; Rezek, Robert; Prochazka, Petr; Krejstova, Gabriela; Neumann, Jiri; Vachova, Marta; Brzezanski, Henryk; Hlinovsky, David; Tenora, Dusan; Jura, Rene; Jurák, Lubomír; Novak, Jan; Novak, Ales; Topinka, Zdenek; Fibrich, Petr; Sobolova, Helena; Volny, Ondrej; Krarup Christensen, Hanne; Drenck, Nicolas; Klingenberg Iversen, Helle; Simonsen, Claus Z.; Truelsen, Thomas Clement; Wienecke, Troels; Vibo, Riina; Gross-Paju, Katrin; Toomsoo, Toomas; Antsov, Katrin; Caparros, Francois; Cordonnier, Charlotte; Dan, Maria; Faucheux, Jean-Marc; Mechtouff, Laura; Eker, Omer; Lesaine, Emilie; Ondze, Basile; Peres, Roxane; Pico, Fernando; Piotin, Michel; Pop, Raoul; Rouanet, Francois; Gubeladze, Tatuli; Khinikadze, Mirza; Lobjanidze, Nino; Tsiskaridze, Alexander; Nagel, Simon; Ringleb, Peter Arthur; Rosenkranz, Michael; Schmidt, Holger; Sedghi, Annahita; Siepmann, Timo; Szabo, Kristina; Thomalla, Götz; Palaiodimou, Lina; Sagris, Dimitrios; Kargiotis, Odysseas; Klivenyi, Peter; Szapary, Laszlo; Tarkanyi, Gabor; Adami, Alessandro; Bandini, Fabio; Calabresi, Paolo; Frisullo, Giovanni; Renieri, Leonardo; Sangalli, Davide; Pirson, Anne; Uyttenboogaart, Maarten; van den Wijngaard, Ido; Kristoffersen, Espen Saxhaug; Brola, Waldemar; Fudala, Małgorzata; Horoch-Lyszczarek, Ewa; Karlinski, Michal; Kazmierski, Radoslaw; Kram, Pawel; Rogoziewicz, Marcin; Kaczorowski, Rafal; Luchowski, Piotr; Sienkiewicz-Jarosz, Halina; Sobolewski, Piotr; Fryze, Waldemar; Wisniewska, Anna; Wiszniewska, Malgorzata; Ferreira, Patricia; Ferreira, Paulo; Fonseca, Luisa; Marto, João Pedro; Pinho e Melo, Teresa; Nunes, Ana Paiva; Rodrigues, Miguel; Tedim Cruz, Vítor; Falup-Pecurariu, Cristian; Krastev, Georgi; Mako, Miroslav; de Leciñana, María Alonso; Arenillas, Juan F.; Ayo-Martin, Oscar; Cruz Culebras, Antonio; Tejedor, Exuperio Diez; Montaner, Joan; Pérez-Sánchez, Soledad; Tola Arribas, Miguel Angel; Rodriguez Vasquez, Alejandro; Mayza, Michael; Bernava, Gianmarco; Brehm, Alex; Machi, Paolo; Fischer, Urs; Gralla, Jan; Michel, Patrik L.; Psychogios, Marios-Nikos; Strambo, Davide; Banerjee, Soma; Krishnan, Kailash; Kwan, Joseph; Butt, Asif; Catanese, Luciana; Demchuk, Andrew M.; Field, Thalia; Haynes, Jennifer; Hill, Michael D.; Khosravani, Houman; Mackey, Ariane; Pikula, Aleksandra; Saposnik, Gustavo; Scott, Courtney Anne; Shoamanesh, Ashkan; Shuaib, Ashfaq; Yip, Samuel; Barboza, Miguel A.; Barrientos, Jose Domingo; Portillo Rivera, Ligia Ibeth; Gongora-Rivera, Fernando; Novarro-Escudero, Nelson; Blanco, Anmylene; Abraham, Michael; Alsbrook, Diana; Altschul, Dorothea; Alvarado-Ortiz, Anthony J.; Bach, Ivo; Badruddin, Aamir; Barazangi, Nobl; Brereton, Charmaine; Castonguay, Alicia; Chaturvedi, Seemant; Chaudry, Saqib A.; Choe, Hana; Choi, Jae H.; Dharmadhikari, Sushrut; Desai, Kinjal; Devlin, Thomas G.; Doss, Vinodh T.; Edgell, Randall; Etherton, Mark; Farooqui, Mudassir; Frei, Don; Gandhi, Dheeraj; Grigoryan, Mikayel; Gupta, Rishi; Hassan, Ameer E.; Helenius, Johanna; Kaliaev, Artem; Kaushal, Ritesh; Khandelwal, Priyank; Khawaja, Ayaz M.; Khoury, Naim N.; Kim, Benny S.; Kleindorfer, Dawn O.; Koyfman, Feliks; Lee, Vivien H.; Leung, Lester Y.; Linares, Guillermo; Linfante, Italo; Lutsep, Helmi L.; Macdougall, Lisa; Male, Shailesh; Malik, Amer M.; Masoud, Hesham; McDermott, Molly; Mehta, Brijesh P.; Min, Jiangyong; Mittal, Manoj; Morris, Jane G.; Multani, Sumeet S.; Nahab, Fadi; Nalleballe, Krishna; Nguyen, Claude B.; Novakovic-White, Roberta; Ortega-Gutierrez, Santiago; Rahangdale, Rahul H.; Ramakrishnan, Pankajavalli; Romero, Jose Rafael; Rost, Natalia; Rothstein, Aaron; Ruland, Sean; Shah, Ruchir; Sharma, Malveeka; Silver, Brian; Simmons, Marc; Singh, Abhishek; Starosciak, Amy K.; Strasser, Sheryl L.; Szeder, Viktor; Teleb, Mohamed; Tsai, Jenny P.; Voetsch, Barbara; Balaguera, Oscar; Pujol Lereis, Virginia A.; Luraschi, Adriana; Almeida, Marcele Schettini; Cardoso, Fabricio Buchdid; Conforto, Adriana; De Deus Silva, Leonardo; Varrone Giacomini, Luidia; Oliveira Lima, Fabricio; Longo, Alexandre L.; Magalhães, Pedro S.C.; Martins, Rodrigo Targa; Mont'alverne, Francisco; Mora Cuervo, Daissy Liliana; Costa Rebello, Leticia; Valler, Lenise; Zetola, Viviane Flumignan; Lavados, Pablo M.; Navia, Victor; Olavarría, Verónica V.; Almeida Toro, Juan Manuel; Amaya, Pablo Felipe Ricardo; Bayona, Hernan; Corredor, Angel; Rivera Ordonez, Carlos Eduardo; Mantilla Barbosa, Diana Katherine; Lara, Osvaldo; Patiño, Mauricio R.; Diaz Escobar, Luis Fernando; Dejesus Melgarejo Farina, Donoband Edson; Cardozo Villamayor, Analia; Zelaya Zarza, Adolfo Javier; Barrientos Iman, Danny Moises; Rodriguez Kadota, Liliana; Campbell, Bruce; Hankey, Graeme J.; Hair, Casey; Kleinig, Timothy; Ma, Alice; Tomazini Martins, Rodrigo; Sahathevan, Ramesh; Thijs, Vincent; Salazar, Daniel; Yuan-Hao Wu, Teddy; Haussen, Diogo C.; Liebeskind, David; Yavagal, Dileep R.; Jovin, Tudor G.; Zaidat, Osama O.; Nguyen, Thanh N.;
• Is Part Of: Neurology. Volume 96:Number 23(2021)
• Publication Date: 2021-06-08
• Subjects: Neurology -- Periodicals; Neurology -- Periodicals; Neurologie -- Périodiques; 616.8
• DOI: 10.1212/WNL.0000000000011885
• Languages: English
• ISSNs: 0028-3878

Abstract

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: 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.