Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic. Issue 4 (26th March 2021)

• Record Type: Journal Article
• Authors: Nguyen, Thanh N; Haussen, Diogo C; Qureshi, Muhammad M; Yamagami, Hiroshi; Fujinaka, Toshiyuki; Mansour, Ossama Y; Abdalkader, Mohamad; Frankel, Michael; Qiu, Zhongming; Taylor, Allan; Lylyk, Pedro; Eker, Omer F; Mechtouff, Laura; Piotin, Michel; Lima, Fabricio Oliveira; Mont'Alverne, Francisco; Izzath, Wazim; Sakai, Nobuyuki; Mohammaden, Mahmoud; Al-Bayati, Alhamza R; Renieri, Leonardo; Mangiafico, Salvatore; Ozretic, David; Chalumeau, Vanessa; Ahmad, Saima; Rashid, Umair; Hussain, Syed Irteza; John, Seby; Griffin, Emma; Thornton, John; Fiorot, Jose Antonio; Rivera, Rodrigo; Hammami, Nadia; Cervantes-Arslanian, Anna M; Dasenbrock, Hormuzdiyar H; Vu, Huynh Le; Nguyen, Viet Quy; Hetts, Steven; Bourcier, Romain; Guile, Romain; Walker, Melanie; Sharma, Malveeka; Frei, Don; Jabbour, Pascal; Herial, Nabeel; Al-Mufti, Fawaz; Ozdemir, Atilla Ozcan; Aykac, Ozlem; Gandhi, Dheeraj; Chugh, Chandril; Matouk, Charles; Lavoie, Pascale; Edgell, Randall; Beer-Furlan, Andre; Chen, Michael; Killer-Oberpfalzer, Monika; Pereira, Vitor Mendes; Nicholson, Patrick; Huded, Vikram; Ohara, Nobuyuki; Watanabe, Daisuke; Shin, Dong Hun; Magalhaes, Pedro SC; Kikano, Raghid; Ortega-Gutierrez, Santiago; Farooqui, Mudassir; Abou-Hamden, Amal; Amano, Tatsuo; Yamamoto, Ryoo; Weeks, Adrienne; Cora, Elena A; Sivan-Hoffmann, Rotem; Crosa, Roberto; Möhlenbruch, Markus; Nagel, Simon; Al-Jehani, Hosam; Sheth, Sunil A; Lopez Rivera, Victor S; Siegler, James E; Sani, Achmad Fidaus; Puri, Ajit S; Kuhn, Anna Luisa; Bernava, Gianmarco; Machi, Paolo; Abud, Daniel G; Pontes-Neto, Octavio M; Wakhloo, Ajay K; Voetsch, Barbara; Raz, Eytan; Yaghi, Shadi; Mehta, Brijesh P; Kimura, Naoto; Murakami, Mamoru; Lee, Jin Soo; Hong, Ji Man; Fahed, Robert; Walker, Gregory; Hagashi, Eiji; Cordina, Steve M; Roh, Hong Gee; Wong, Ken; Arenillas, Juan F; Martinez-Galdamez, Mario; Blasco, Jordi; Rodriguez Vasquez, Alejandro; Fonseca, Luisa; Silva, M Luis; Wu, Teddy Y; John, Simon; Brehm, Alex; Psychogios, Marios; Mack, William J; Tenser, Matthew; Todaka, Tatemi; Fujimura, Miki; Novakovic, Roberta; Deguchi, Jun; Sugiura, Yuri; Tokimura, Hiroshi; Khatri, Rakesh; Kelly, Michael; Peeling, Lissa; Murayama, Yuichi; Winters, Hugh Stephen; Wong, Johnny; Teleb, Mohamed; Payne, Jeremy; Fukuda, Hiroki; Miyake, Kosuke; Shimbo, Junsuke; Sugimura, Yusuke; Uno, Masaaki; Takenobu, Yohei; Matsumaru, Yuji; Yamada, Satoshi; Kono, Ryuhei; Kanamaru, Takuya; Morimoto, Masafumi; Iida, Junichi; Saini, Vasu; Yavagal, Dileep; Bushnaq, Saif; Huang, Wenguo; Linfante, Italo; Kirmani, Jawad; Liebeskind, David S; Szeder, Viktor; Shah, Ruchir; Devlin, Thomas G; Birnbaum, Lee; Luo, Jun; Churojana, Anchalee; Masoud, Hesham E; Lopez, Carlos Ynigo; Steinfort, Brendan; Ma, Alice; Hassan, Ameer E; Al Hashmi, Amal; McDermott, Mollie; Mokin, Maxim; Chebl, Alex; Kargiotis, Odysseas; Tsivgoulis, Georgios; Morris, Jane G; Eskey, Clifford J; Thon, Jesse; Rebello, Leticia; Altschul, Dorothea; Cornett, Oriana; Singh, Varsha; Pandian, Jeyaraj; Kulkarni, Anirudh; Lavados, Pablo M; Olavarria, Veronica V; Todo, Kenichi; Yamamoto, Yuki; Silva, Gisele Sampaio; Geyik, Serdar; Johann, Jasmine; Multani, Sumeet; Kaliaev, Artem; Sonoda, Kazutaka; Hashimoto, Hiroyuki; Alhazzani, Adel; Chung, David Y; Mayer, Stephan A; Fifi, Johanna T; Hill, Michael D; Zhang, Hao; Yuan, Zhengzhou; Shang, Xianjin; Castonguay, Alicia C; Gupta, Rishi; Jovin, Tudor G; Raymond, Jean; Zaidat, Osama O; Nogueira, Raul G;
• Is Part Of: Stroke and vascular neurology. Volume 6:Issue 4(2021)
• Page Start: 542
• Page End: 552
• Publication Date: 2021-03-26
• Subjects: aneurysm -- coil -- haemorrhage -- infection -- subarachnoid; Cerebrovascular disease -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; 616.81005
• DOI: 10.1136/svn-2020-000695
• Languages: English
• ISSNs: 2059-8688

Abstract

Abstract : Background: During the COVID-19 pandemic, decreased volumes of stroke admissions and mechanical thrombectomy were reported. The study's objective was to examine whether subarachnoid haemorrhage (SAH) hospitalisations and ruptured aneurysm coiling interventions demonstrated similar declines. Methods: We conducted a cross-sectional, retrospective, observational study across 6 continents, 37 countries and 140 comprehensive stroke centres. Patients with the diagnosis of SAH, aneurysmal SAH, ruptured aneurysm coiling interventions and COVID-19 were identified by prospective aneurysm databases or by International Classification of Diseases, 10th Revision, codes. The 3-month cumulative volume, monthly volumes for SAH hospitalisations and ruptured aneurysm coiling procedures were compared for the period before (1 year and immediately before) and during the pandemic, defined as 1 March–31 May 2020. The prior 1-year control period (1 March–31 May 2019) was obtained to account for seasonal variation. Findings: There was a significant decline in SAH hospitalisations, with 2044 admissions in the 3 months immediately before and 1585 admissions during the pandemic, representing a relative decline of 22.5% (95% CI −24.3% to −20.7%, p<0.0001). Embolisation of ruptured aneurysms declined with 1170–1035 procedures, respectively, representing an 11.5% (95%CI −13.5% to −9.8%, p=0.002) relative drop. Subgroup analysis was noted for aneurysmal SAH hospitalisation decline from 834 to 626 hospitalisations, a 24.9% relative decline (95% CI −28.0% to −22.1%, p<0.0001). A relative increase in ruptured aneurysm coiling was noted in low coiling volume hospitals of 41.1% (95% CI 32.3% to 50.6%, p=0.008) despite a decrease in SAH admissions in this tertile. Interpretation: There was a relative decrease in the volume of SAH hospitalisations, aneurysmal SAH hospitalisations and ruptured aneurysm embolisations during the COVID-19 pandemic. These findings in SAH are consistent with a decrease in other emergencies, such as stroke and myocardial infarction.