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Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic

Authors
Nguyen, TN | Haussen, DC | Qureshi, MM | Yamagami, H | Fujinaka, T | Mansour, OY | Abdalkader, M | Frankel, M | Qiu, Z | Taylor, A | Lylyk, P | Eker, OF | Mechtouff, L | Piotin, M | Lima, FO | Mont'Alverne, F | Izzath, W | Sakai, N | Mohammaden, M | Al-Bayati, AR | Renieri, L | Mangiafico, S | Ozretic, D | Chalumeau, V | Ahmad, S | Rashid, U | Hussain, SI | John, S | Griffin, E | Thornton, J | Fiorot, JA | Rivera, R | Hammami, N | Cervantes-Arslanian, AM | Dasenbrock, HH | Vu, HL | Nguyen, VQ | Hetts, S | Bourcier, R | Guile, R | Walker, M | Sharma, M | Frei, D | Jabbour, P | Herial, N | Al-Mufti, F | Ozdemir, AO | Aykac, O | Gandhi, D | Chugh, C | Matouk, C | Lavoie, P | Edgell, R | Beer-Furlan, A | Chen, M | Killer-Oberpfalzer, M | Pereira, VM | Nicholson, P | Huded, V | Ohara, N | Watanabe, D | Shin, DH | Magalhaes, PSC | Kikano, R | Ortega-Gutierrez, S | Farooqui, M | Abou-Hamden, A | Amano, T | Yamamoto, R | Weeks, A | Cora, EA | Sivan-Hoffmann, R | Crosa, R | Möhlenbruch, M | Nagel, S | Al-Jehani, H | Sheth, SA | Rivera, VSL | Siegler, JE | Sani, AF | Puri, AS | Kuhn, AL | Bernava, G | Machi, P | Abud, DG | Pontes-Neto, OM | Wakhloo, AK | Voetsch, B | Raz, E | Yaghi, S | Mehta, BP | Kimura, N | Murakami, M | Lee, JS  | Hong, JM  | Fahed, R | Walker, G | Hagashi, E | Cordina, SM | Roh, HG | Wong, K | Arenillas, JF | Martinez-Galdamez, M | Blasco, J | Vasquez, AR | Fonseca, L | Silva, ML | Wu, TY | John, S | Brehm, A | Psychogios, M | Mack, WJ | Tenser, M | Todaka, T | Fujimura, M | Novakovic, R | Deguchi, J | Sugiura, Y | Tokimura, H | Khatri, R | Kelly, M | Peeling, L | Murayama, Y | Winters, HS | Wong, J | Teleb, M | Payne, J | Fukuda, H | Miyake, K | Shimbo, J | Sugimura, Y | Uno, M | Takenobu, Y | Matsumaru, Y | Yamada, S | Kono, R | Kanamaru, T | Morimoto, M | Iida, J | Saini, V | Yavagal, D | Bushnaq, S | Huang, W | Linfante, I | Kirmani, J | Liebeskind, DS | Szeder, V | Shah, R | Devlin, TG | Birnbaum, L | Luo, J | Churojana, A | Masoud, HE | Lopez, CY | Steinfort, B | Ma, A | Hassan, AE | Al Hashmi, A | McDermott, M | Mokin, M | Chebl, A | Kargiotis, O | Tsivgoulis, G | Morris, JG | Eskey, CJ | Thon, J | Rebello, L | Altschul, D | Cornett, O | Singh, V | Pandian, J | Kulkarni, A | Lavados, PM | Olavarria, VV | Todo, K | Yamamoto, Y | Silva, GS | Geyik, S | Johann, J | Multani, S | Kaliaev, A | Sonoda, K | Hashimoto, H | Alhazzani, A | Chung, DY | Mayer, SA | Fifi, JT | Hill, MD | Zhang, H | Yuan, Z | Shang, X | Castonguay, AC | Gupta, R | Jovin, TG | Raymond, J | Zaidat, OO | Nogueira, RG | SVIN COVID-19 Registry, the Middle East North Africa Stroke and Interventional Neurotherapies Organization (MENA-SINO) | Japanese Society of Vascular and Interventional Neurology Society (JVIN)
Citation
Stroke and vascular neurology, 6(4). : 542-552, 2021
Journal Title
Stroke and vascular neurology
ISSN
2059-86882059-8696
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.
Keywords

MeSH

DOI
10.1136/svn-2020-000695
PMID
33771936
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Neurology
Ajou Authors
이, 진수  |  홍, 지만
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