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Journal Articles Stroke and Vascular Neurology Year : 2021

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

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T. N. Nguyen
  • Function : Author
  • PersonId : 5093
  • IdHAL : nghi-nguyen
A. Taylor
M. Chen
J. S. Lee
  • Function : Author
J. M. Hong
  • Function : Author
A. Ma
  • Function : Author
Y. Yamamoto
M. D. Hill
  • Function : Author

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\textless0.0001). 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\textless0.0001). 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.
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Dates and versions

inserm-03337432 , version 1 (08-09-2021)

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T. N. Nguyen, D. C. Haussen, M. M. Qureshi, H. Yamagami, T. Fujinaka, et al.. Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic. Stroke and Vascular Neurology, 2021, pp.svn-2020-000695. ⟨10.1136/svn-2020-000695⟩. ⟨inserm-03337432⟩
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