Global impact of COVID-19 on stroke care and IV thrombolysis

• Author(s): Nogueira, Raul G. ; Qureshi, Muhammad M. ; Abdalkader, Mohamad ; Martins, Sheila Ouriques ; Yamagami, Hiroshi ; Qiu, Zhongming ; Mansour, Ossama Yassin ; Sathya, Anvitha ; Czlonkowska, Anna ; Tsivgoulis, Georgios ; de Sousa, Diana Aguiar ; Uwatoko, Takeshi ; Dembo, Tomohisa ; Shimizu, Hisao ; Sugiura, Yuri ; Miyashita, Fumio ; Fukuda, Hiroki ; Miyake, Kosuke ; Shimbo, Junsuke ; Sugimura, Yusuke ; Yagita, Yoshiki ; Demeestere, Jelle ; Takenobu, Yohei ; Matsumaru, Yuji ; Yamada, Satoshi ; Kono, Ryuhei ; Kanamaru, Takuya ; Yamazaki, Hidekazu ; Sakaguchi, Manabu ; Todo, Kenichi ; Yamamoto, Nobuaki ; Sonoda, Kazutaka ; Mikulik, Robert ; Yoshida, Tomoko ; Hashimoto, Hiroyuki ; Nakahara, Ichiro ; Kondybayeva, Aida ; Faizullina, Kamila ; Kamenova, Saltanat ; Zhanuzakov, Murat ; Baek, Jang-Hyun ; Hwang, Yangha ; Lee, Jin Soo ; Vanacker, Peter ; 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 ; Siegler, James E. ; 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. ; Kõrv, Janika ; 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 ; Biller, Jose ; 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 ; Liang, Conrad W. ; 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 ; Sangha, Navdeep S. ; Vanhooren, Geert ; De Raedt, Sylvie ; Dusart, Anne ; Lemmens, Robin ; Ligot, Noemie ; Pierre Rutgers, Matthieu ; Yperzeele, Laetitia ; Alexiev, Filip ; Sakelarova, Teodora ; Bedeković, Marina Roje ; Zha, Alicia M. ; Budincevic, Hrvoje ; Cindric, Igor ; Hucika, Zlatko ; Ozretic, David ; Saric, Majda Seferovic ; Pfeifer, František ; Karpowic, Igor ; Cernik, David ; Sramek, Martin ; Skoda, Miroslav ; Czap, Alexandra L. ; Hlavacova, Helena ; Klecka, Lukas ; Koutny, Martin ; Vaclavik, Daniel ; Skoda, Ondrej ; Fiksa, Jan ; Hanelova, Katerina ; Nevsimalova, Miroslava ; Rezek, Robert ; Prochazka, Petr ; Holmstedt, Christine Anne ; Krejstova, Gabriela ; Neumann, Jiri ; Vachova, Marta ; Brzezanski, Henryk ; Hlinovsky, David ; Tenora, Dusan ; Jura, Rene ; Jurák, Lubomír ; Novak, Jan ; Novak, Ales ; Turan, Tanya N. ; Topinka, Zdenek ; Fibrich, Petr ; Sobolova, Helena ; Volny, Ondrej ; Krarup Christensen, Hanne ; Drenck, Nicolas ; Klingenberg Iversen, Helle ; Simonsen, Claus Z. ; Truelsen, Thomas Clement ; Wienecke, Troels ; Ntaios, George ; Vibo, Riina ; Gross-Paju, Katrin ; Toomsoo, Toomas ; Antsov, Katrin ; Caparros, Francois ; Cordonnier, Charlotte ; Dan, Maria ; Faucheux, Jean-Marc ; Mechtouff, Laura ; Eker, Omer ; Malhotra, Konark ; Lesaine, Emilie ; Ondze, Basile ; Peres, Roxane ; Pico, Fernando ; Piotin, Michel ; Pop, Raoul ; Rouanet, Francois ; Gubeladze, Tatuli ; Khinikadze, Mirza ; Lobjanidze, Nino ; Tayal, Ashis ; Tsiskaridze, Alexander ; Nagel, Simon ; Ringleb, Peter Arthur ; Rosenkranz, Michael ; Schmidt, Holger ; Sedghi, Annahita ; Siepmann, Timo ; Szabo, Kristina ; Thomalla, Götz ; Palaiodimou, Lina ; Loochtan, Aaron ; Sagris, Dimitrios ; Kargiotis, Odysseas ; Klivenyi, Peter ; Szapary, Laszlo ; Tarkanyi, Gabor ; Adami, Alessandro ; Bandini, Fabio ; Calabresi, Paolo ; Frisullo, Giovanni ; Renieri, Leonardo ; Ranta, Annamarei ; Sangalli, Davide ; Pirson, Anne ; Uyttenboogaart, Maarten ; van den Wijngaard, Ido ; Kristoffersen, Espen Saxhaug ; Brola, Waldemar ; Fudala, Małgorzata ; Horoch-Lyszczarek, Ewa ; Karlinski, Michal ; Kazmierski, Radoslaw ; Mistry, Eva A. ; Kram, Pawel ; Rogoziewicz, Marcin ; Kaczorowski, Rafal ; Luchowski, Piotr ; Sienkiewicz-Jarosz, Halina ; Sobolewski, Piotr ; Fryze, Waldemar ; Wisniewska, Anna ; Wiszniewska, Malgorzata ; Ferreira, Patricia ; Alexandrov, Anne W. ; Ferreira, Paulo ; Fonseca, Luisa ; Marto, João Pedro ; Melo, Teresa Pinho e ; Nunes, Ana Paiva ; Rodrigues, Miguel ; Tedim Cruz, Vítor ; Falup-Pecurariu, Cristian ; Krastev, Georgi ; Mako, Miroslav ; Huang, David Y. ; 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 ; Yaghi, Shadi ; Bernava, Gianmarco ; Brehm, Alex ; Machi, Paolo ; Fischer, Urs ; Gralla, Jan ; Michel, Patrik L. ; Psychogios, Marios-Nikos ; Strambo, Davide ; Banerjee, Soma ; Krishnan, Kailash ; Raz, Eytan ; Kwan, Joseph ; Butt, Asif ; Catanese, Luciana ; Demchuk, Andrew M. ; Field, Thalia ; Haynes, Jennifer ; Hill, Michael D. ; Khosravani, Houman ; Mackey, Ariane ; Pikula, Aleksandra ; Sheth, Sunil A. ; 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 ; Mohammaden, Mahmoud H. ; Blanco, Anmylene ; Abraham, Michael ; Alsbrook, Diana ; Altschul, Dorothea ; Alvarado-Ortiz, Anthony J. ; Bach, Ivo ; Badruddin, Aamir ; Barazangi, Nobl ; Brereton, Charmaine ; Castonguay, Alicia ; Frankel, Michael ; Chaturvedi, Seemant ; Chaudry, Saqib A. ; Choe, Hana ; Choi, Jae H. ; Dharmadhikari, Sushrut ; Desai, Kinjal ; Devlin, Thomas G. ; Doss, Vinodh T. ; Edgell, Randall ; Etherton, Mark ; Bila Lamou, Eric Guemekane ; Farooqui, Mudassir ; Frei, Don ; Gandhi, Dheeraj ; Grigoryan, Mikayel ; Gupta, Rishi ; Hassan, Ameer E. ; Helenius, Johanna ; Kaliaev, Artem ; Kaushal, Ritesh ; Khandelwal, Priyank ; Aref, Hany M. ; 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. ; Elbassiouny, Ahmed ; Macdougall, Lisa ; Male, Shailesh ; Malik, Amer M. ; Masoud, Hesham ; McDermott, Molly ; Mehta, Brijesh P. ; Min, Jiangyong ; Mittal, Manoj ; Morris, Jane G. ; Multani, Sumeet S. ; Hassan, Farouk ; 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 ; Menecie, Tarek ; Ruland, Sean ; Shah, Ruchir ; Sharma, Malveeka ; Silver, Brian ; Simmons, Marc ; Singh, Abhishek ; Starosciak, Amy K. ; Strasser, Sheryl L. ; Szeder, Viktor ; Teleb, Mohamed ; Mustafa, Wessam ; 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 ; Shokri, Hossam M. ; 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. ; Roushdy, Tamer ; 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. ; Sarfo, Fred S. ; Diaz Escobar, Luis Fernando ; Dejesus Melgarejo Fariña, 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 ; Alabi, Tolulope Oyetunde ; 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. ; Arabambi, Babawale ; Zaidat, Osama O. ; Nguyen, Thanh N. ; 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
• Date: 2021
• Persistent ID: http://hdl.handle.net/10451/49594
• Origin: Repositório da Universidade de Lisboa
• Document Type: Journal article
• Language: English
• Contributor(s): Repositório Científico de Acesso Aberto da ULisboa

Description

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.