Journal article
Global Impact of COVID-19 on Stroke Care and IV Thrombolysis
Neurology, Vol.96(23), pp.e2824-e2838
06/08/2021
DOI: 10.1212/WNL.0000000000011885
PMCID: PMC8205458
PMID: 33766997
Abstract
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.
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.
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,
< 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,
< 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,
= 0.001). Recovery of stroke hospitalization volume (9.5%, 95% CI 9.2-9.8,
< 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.
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.
Details
- Title: Subtitle
- Global Impact of COVID-19 on Stroke Care and IV Thrombolysis
- Creators
- Raul G NogueiraMuhammad M QureshiMohamad AbdalkaderSheila Ouriques MartinsHiroshi YamagamiZhongming QiuOssama Yassin MansourAnvitha SathyaAnna CzlonkowskaGeorgios TsivgoulisTanya N TuranPaulo FerreiraGeorge NtaiosJoan MontanerKonark MalhotraJelle DemeestereAshis TayalAaron LoochtanAlex BrehmLuisa FonsecaAnnamarei RantaEva A MistryAnne W AlexandrovRobert MikulikPaolo MachiDavid Y HuangShadi YaghiJoão Pedro MartoEytan RazSoledad Pérez-SánchezPeter VanackerSunil A ShethUrs FischerMahmoud H MohammadenTeresa Pinho E MeloMichael FrankelEric Guemekane Bila LamouJames E SieglerHany M ArefJan GrallaAhmed ElbassiounyFarouk HassanAna Paiva NunesTarek MenecieWessam MustafaHossam M ShokriTamer RoushdyFred S SarfoTolulope Oyetunde AlabiBabawale ArabambiErnest O NwazorTaofiki Ajao SunmonuKolawole WahabJoseph YariaHaytham Hussein MohammedPhilip B AdebayoAnis D RiahiSamia Ben SassiLenon GwaunzaGift Wilson NgwendeDavid SahakyanAminur RahmanZhibing AiChandril ChughFanghui BaiZhenhui DuanVikram HudedYonggang HaoBindu MenonJeyaraj Durai PandianWenguo HuangGuangwen LiP N SylajaFritz Sumantri UsmanWei LiMehdi FarhoudiGanzhe LiuElyar Sadeghi HokmabadiJun LuoXianjin ShangAnat HorevYi SuiAnna ReznikRotem Sivan HoffmannLing TianHongbin WenNobuyuki OharaNobuyuki SakaiBo WuDaisuke WatanabeYuying YanZhengzhou YuanRyoo YamamotoHao ZhangRyosuke DoijiriJun ZhangNaoki TokudaTakehiro YamadaWenlong ZhaoTadashi TerasakiWenjie ZiYukako YazawaThomas W LeungTakeshi UwatokoTomohisa DemboHisao ShimizuYuri SugiuraFumio MiyashitaHiroki FukudaKosuke MiyakeJunsuke ShimboYusuke SugimuraYoshiki YagitaYohei TakenobuYuji MatsumaruSatoshi YamadaRyuhei KonoTakuya KanamaruHidekazu YamazakiManabu SakaguchiKenichi TodoNobuaki YamamotoKazutaka SonodaTomoko YoshidaHiroyuki HashimotoIchiro NakaharaAida KondybayevaKamila FaizullinaSaltanat KamenovaMurat ZhanuzakovJang-Hyun BaekYangha HwangJin Soo LeeSi Baek LeeJusun MoonHyungjong ParkJung Hwa SeoKwon-Duk SeoSung Il SohnChang Jun YoungRechdi AhdabWan Asyraf Wan ZaidiZariah Abdul AzizHamidon Bin BasriChih-Hao ChenGeert VanhoorenLaw Wan ChungSylvie De RaedtSung-Chun TangAznita Binti IbrahimAnchalee ChurojanaAnne DusartRobin LemmensKhairul Azmi IbrahimEsref AkilNoemie LigotIrene LooiÖzlem AykaçMatthieu Pierre RutgersWee Yong TanAtilla Ozcan OzdemirNafisah Wan YahyaSemih GirayLaetitia YperzeeleStanislav GroppaSyed Irteza HussainFilip AlexievPavel LeahuSeby JohnTeodora SakelarovaAmal M Al HashmiHuynh Le VuMarina Roje BedekovićYahia Zakaria ImamNaveed AkhtarMaria Carissa Pineda-FranksChristian Oliver CoDmitriy KandybaAdel AlhazzaniHosam Al-JehaniCarol Huilian ThamMarlie Jane MamauagNarayanaswamy VenketasubramanianAnh Duc TranHrvoje BudincevicHuy Hoang NguyenIgor CindricThong Nhu PhamZlatko HucikaThang Huy NguyenDavid OzreticTrung Quoc NguyenMajda Seferovic SaricThomas GattringerFrantišek PfeiferChristian EnzingerIgor KarpowicMonika Killer-OberpfalzerDavid CernikFlavio BellanteMartin SramekSofie De BlauweMiroslav SkodaHelena HlavacovaLukas KleckaMartin KoutnyDaniel VaclavikOndrej SkodaJan FiksaKaterina HanelovaMiroslava NevsimalovaRobert RezekPetr ProchazkaGabriela KrejstovaJiri NeumannMarta VachovaHenryk BrzezanskiDavid HlinovskyDusan TenoraRene JuraLubomír JurákJan NovakAles NovakZdenek TopinkaDimitrios SagrisPetr FibrichOdysseas KargiotisHelena SobolovaPeter KlivenyiOndrej VolnyLaszlo SzaparyHanne Krarup ChristensenGabor TarkanyiNicolas DrenckAlessandro AdamiHelle Klingenberg IversenFabio BandiniClaus Z SimonsenPaolo CalabresiThomas Clement TruelsenGiovanni FrisulloTroels WieneckeLeonardo RenieriRiina ViboDavide SangalliKatrin Gross-PajuAnne PirsonToomas ToomsooMaarten UyttenboogaartKatrin AntsovIdo van den WijngaardFrancois CaparrosEspen Saxhaug KristoffersenCharlotte CordonnierWaldemar BrolaMaria DanMałgorzata FudalaJean-Marc FaucheuxEwa Horoch-LyszczarekLaura MechtouffMichal KarlinskiOmer EkerRadoslaw KazmierskiEmilie LesaineBasile OndzeRoxane PeresFrancois RouanetTatuli GubeladzeMirza KhinikadzeNino LobjanidzeAlexander TsiskaridzeSimon NagelPeter Arthur RinglebMichael RosenkranzHolger SchmidtAnnahita SedghiTimo SiepmannKristina SzaboGötz ThomallaLina PalaiodimouJoseph KwanAsif ButtLuciana CataneseAndrew M DemchukThalia FieldJennifer HaynesMichael D HillHouman KhosravaniAriane MackeyAleksandra PikulaGustavo SaposnikCourtney Anne ScottAshkan ShoamaneshAshfaq ShuaibSamuel YipMiguel A BarbozaJose Domingo BarrientosLigia Ibeth Portillo RiveraFernando Gongora-RiveraNelson Novarro-EscuderoAnmylene BlancoMichael AbrahamDiana AlsbrookDorothea AltschulAnthony J Alvarado-OrtizIvo BachAamir BadruddinNobl BarazangiCharmaine BreretonAlicia CastonguaySeemant ChaturvediSaqib A ChaudryHana ChoeJae H ChoiSushrut DharmadhikariKinjal DesaiThomas G DevlinVinodh T DossRandall EdgellMark EthertonMudassir FarooquiDon FreiDheeraj GandhiMikayel GrigoryanRishi GuptaAmeer E HassanJohanna HeleniusArtem KaliaevRitesh KaushalPriyank KhandelwalAyaz M KhawajaNaim N KhouryBenny S KimDawn O KleindorferFeliks KoyfmanVivien H LeeLester Y LeungGuillermo LinaresItalo LinfanteHelmi L LutsepLisa MacdougallShailesh MaleAmer M MalikHesham MasoudMolly McDermottBrijesh P MehtaJiangyong MinManoj MittalJane G MorrisSumeet S MultaniFadi NahabKrishna NalleballeClaude B NguyenRoberta Novakovic-WhiteSantiago Ortega-GutierrezRahul H RahangdalePankajavalli RamakrishnanJose Rafael RomeroNatalia RostAaron RothsteinSean RulandRuchir ShahMalveeka SharmaBrian SilverMarc SimmonsAbhishek SinghAmy K StarosciakSheryl L StrasserViktor SzederMohamed TelebJenny P TsaiBarbara VoetschOscar BalagueraVirginia A Pujol LereisAdriana LuraschiMarcele Schettini AlmeidaFabricio Buchdid CardosoAdriana ConfortoLeonardo De Deus SilvaLuidia Varrone GiacominiFabricio Oliveira LimaAlexandre L LongoPedro S C MagalhãesRodrigo Targa MartinsFrancisco Mont'alverneDaissy Liliana Mora CuervoLeticia Costa RebelloLenise VallerViviane Flumignan ZetolaPablo M LavadosVictor NaviaVerónica V OlavarríaJuan Manuel Almeida ToroPablo Felipe Ricardo AmayaHernan BayonaAngel CorredorCarlos Eduardo Rivera OrdonezDiana Katherine Mantilla BarbosaOsvaldo LaraMauricio R PatiñoLuis Fernando Diaz EscobarDonoband Edson Dejesus Melgarejo FariñaAnalia Cardozo VillamayorAdolfo Javier Zelaya ZarzaDanny Moises Barrientos ImanLiliana Rodriguez KadotaBruce CampbellGraeme J HankeyCasey HairTimothy KleinigAlice MaRodrigo Tomazini MartinsRamesh SahathevanVincent ThijsDaniel SalazarTeddy Yuan-Hao WuDiogo C HaussenDavid LiebeskindDileep R YavagalTudor G JovinOsama O ZaidatThanh N NguyenSVIN COVID-19 Global Stroke RegistryFernando PicoMichel PiotinRaoul PopPawel KramMarcin RogoziewiczRafal KaczorowskiMaría Alonso de LeciñanaJuan F ArenillasPiotr LuchowskiHalina Sienkiewicz-JaroszOscar Ayo-MartinPiotr SobolewskiWaldemar FryzeAntonio Cruz CulebrasMiguel Angel Tola ArribasMiguel RodriguesAlejandro Rodriguez VasquezMarios-Nikos PsychogiosAnna WisniewskaMalgorzata WiszniewskaConrad W LiangCristian Falup-PecurariuDavide StramboJanika KõrvExuperio Diez TejedorSoma BanerjeeGeorgi KrastevNavdeep S SanghaVítor Tedim CruzJose BillerPatrik L MichelPatricia FerreiraMichael MayzaAlicia M ZhaKailash KrishnanMiroslav MakoAlexandra L CzapChristine Anne HolmstedtDiana Aguiar de SousaGianmarco Bernava
- Resource Type
- Journal article
- Publication Details
- Neurology, Vol.96(23), pp.e2824-e2838
- DOI
- 10.1212/WNL.0000000000011885
- PMID
- 33766997
- PMCID
- PMC8205458
- ISSN
- 0028-3878
- eISSN
- 1526-632X
- Language
- English
- Date published
- 06/08/2021
- Academic Unit
- Neurology; Radiology; Neurosurgery
- Record Identifier
- 9984303016502771
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