Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic
Date
2021
Type:
Article
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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.
Description
Pascale Lavoie; Randall Edgell; Andre Beer-Furlan; Michael Chen; Monika Killer-Oberpfalzer; Vitor Mendes Pereira; Patrick Nicholson; Vikram Huded; Nobuyuki Ohara; Daisuke Watanabe; Dong Hun Shin; Pedro SC Magalhaes; Raghid Kikano; Santiago Ortega-Gutierrez; Mudassir Farooqui; Amal Abou-Hamden; Tatsuo Amano; Ryoo Yamamoto; Mollie McDermott; Maxim Mokin; Alex Chebl;Odysseas Kargiotis; Georgios Tsivgoulis; Jane G Morris; Clifford J Eskey; Jesse Thon; Leticia Rebello; Dorothea Altschul; Oriana Cornett; Varsha Singh; Jeyaraj Pandian; Anirudh Kulkarni; Pablo M Lavados; Veronica V Olavarria; Kenichi Todo; Yuki Yamamoto; Gisele Sampaio Silva; Serdar Geyik; Jasmine Johann; Sumeet Multani; Artem Kaliaev; Kazutaka Sonoda; Hiroyuki Hashimoto; Adel Alhazzani; David Y Chung; Stephan A Mayer; Johanna T Fifi; Michael D Hill; Hao Zhang; Zhengzhou Yuan; Xianjin Shang; Alicia C Castonguay; Rishi Gupta; Tudor G Jovin; Jean Raymond; Osama O Zaidat; Raul G Nogueira; 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)
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Citation
Nguyen TN, Haussen DC, Qureshi MM Japanese Society of Vascular and Interventional Neurology Society (JVIN), et alDecline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic Stroke and Vascular Neurology 2021;6:doi: 10.1136/svn-2020-000695
Keywords
Aneurysm, Coil, Haemorrhage, Infection, Subarachnoid