Global Impact of COVID-19 on Stroke Care and IV Thrombolysis

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, retrospecti...

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Published in:Neurology Vol. 96; no. 23; p. e2824
Main 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, P N, 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
Format: Journal Article
Language:English
Published: United States 08.06.2021
Subjects:
COVID-19
Cross-Sectional Studies
Hospitalization
Humans
Pandemics
Retrospective Studies
SARS-CoV-2
Stroke - drug therapy
Stroke - epidemiology
Thrombolytic Therapy
ISSN:1526-632X, 1526-632X
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Summary: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.
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ISSN:1526-632X
1526-632X
DOI:10.1212/WNL.0000000000011885