Global Impact of COVID-19 on Stroke Care and IV Thrombolysis
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1
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Sheila Ouriques Martins
- Function : Author
Hiroshi Yamagami
- Function : Author
Zhongming Qiu
- Function : Author
Ossama Yassin Mansour
- Function : Author
Anvitha Sathya
- Function : Author
Anna Czlonkowska
- Function : Author
Georgios Tsivgoulis
- Function : Author
- PersonId : 776614
- ORCID : 0000-0001-5059-4095
- IdRef : 098880470
Diana Aguiar de Sousa
- Function : Author
Jelle Demeestere
- Function : Author
Robert Mikulik
- Function : Author
Peter Vanacker
- Function : Author
James Siegler
- Function : Author
Janika Kõrv
- Function : Author
Jose Biller
- Function : Author
Conrad Liang
- Function : Author
Navdeep Sangha
- Function : Author
Alicia Zha
- Function : Author
Alexandra Czap
- Function : Author
Christine Anne Holmstedt
- Function : Author
George Ntaios
- Function : Author
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- ORCID : 0000-0002-0629-9248
Konark Malhotra
- Function : Author
Ashis Tayal
- Function : Author
Aaron Loochtan
- Function : Author
Annamarei Ranta
- Function : Author
Eva Mistry
- Function : Author
Anne Alexandrov
- Function : Author
David Huang
- Function : Author
Shadi Yaghi
- Function : Author
Eytan Raz
- Function : Author
Sunil Sheth
- Function : Author
Eric Guemekane Bila Lamou
- Function : Author
Hany Aref
- Function : Author
Ahmed Elbassiouny
- Function : Author
Farouk Hassan
- Function : Author
Tarek Menecie
- Function : Author
Wessam Mustafa
- Function : Author
Hossam Shokri
- Function : Author
Tamer Roushdy
- Function : Author
Fred Sarfo
- Function : Author
Tolulope Oyetunde Alabi
- Function : Author
Babawale Arabambi
- Function : Author
Ernest Nwazor
- Function : Author
Taofiki Ajao Sunmonu
- Function : Author
Kolawole Wahab
- Function : Author
Joseph Yaria
- Function : Author
Haytham Hussein Mohammed
- Function : Author
Philip Adebayo
- Function : Author
Anis Riahi
- Function : Author
Samia Ben Sassi
- Function : Author
Lenon Gwaunza
- Function : Author
Gift Wilson Ngwende
- Function : Author
David Sahakyan
- Function : Author
Aminur Rahman
- Function : Author
Zhibing Ai
- Function : Author
Fanghui Bai
- Function : Author
Zhenhui Duan
- Function : Author
Yonggang Hao
- Function : Author
Wenguo Huang
- Function : Author
Guangwen Li
- Function : Author
Wei Li
- Function : Author
Ganzhe Liu
- Function : Author
Jun Luo
- Function : Author
- PersonId : 762145
- ORCID : 0000-0002-3177-0839
Xianjin Shang
- Function : Author
Yi Sui
- Function : Author
Ling Tian
- Function : Author
Hongbin Wen
- Function : Author
Bo Wu
- Function : Author
Yuying Yan
- Function : Author
Zhengzhou Yuan
- Function : Author
Hao Zhang
- Function : Author
Jun Zhang
- Function : Author
Wenlong Zhao
- Function : Author
Wenjie Zi
- Function : Author
Thomas Leung
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Vikram Huded
- Function : Author
Bindu Menon
- Function : Author
Jeyaraj Durai Pandian
- Function : Author
Pn Sylaja
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Fritz Sumantri Usman
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Mehdi Farhoudi
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Elyar Sadeghi Hokmabadi
- Function : Author
Anat Horev
- Function : Author
Anna Reznik
- Function : Author
Rotem Sivan Hoffmann
- Function : Author
Nobuyuki Ohara
- Function : Author
Nobuyuki Sakai
- Function : Author
Daisuke Watanabe
- Function : Author
Ryoo Yamamoto
- Function : Author
Ryosuke Doijiri
- Function : Author
Naoki Tokuda
- Function : Author
Takehiro Yamada
- Function : Author
Tadashi Terasaki
- Function : Author
Yukako Yazawa
- Function : Author
Takeshi Uwatoko
- Function : Author
Tomohisa Dembo
- Function : Author
Hisao Shimizu
- Function : Author
Yuri Sugiura
- Function : Author
Fumio Miyashita
- Function : Author
Hiroki Fukuda
- Function : Author
Kosuke Miyake
- Function : Author
Junsuke Shimbo
- Function : Author
Yusuke Sugimura
- Function : Author
Yoshiki Yagita
- Function : Author
Yohei Takenobu
- Function : Author
Yuji Matsumaru
- Function : Author
Satoshi Yamada
- Function : Author
Ryuhei Kono
- Function : Author
Takuya Kanamaru
- Function : Author
Hidekazu Yamazaki
- Function : Author
Manabu Sakaguchi
- Function : Author
Kenichi Todo
- Function : Author
Nobuaki Yamamoto
- Function : Author
Kazutaka Sonoda
- Function : Author
Tomoko Yoshida
- Function : Author
Hiroyuki Hashimoto
- Function : Author
Ichiro Nakahara
- Function : Author
Aida Kondybayeva
- Function : Author
Kamila Faizullina
- Function : Author
Saltanat Kamenova
- Function : Author
Murat Zhanuzakov
- Function : Author
Jang-Hyun Baek
- Function : Author
Yangha Hwang
- Function : Author
Jin Soo Lee
- Function : Author
Si Baek Lee
- Function : Author
Jusun Moon
- Function : Author
Hyungjong Park
- Function : Author
Jung Hwa Seo
- Function : Author
Kwon-Duk Seo
- Function : Author
Sung Il Sohn
- Function : Author
Chang Jun Young
- Function : Author
Rechdi Ahdab
- Function : Author
Wan Asyraf Wan Zaidi
- Function : Author
Zariah Abdul Aziz
- Function : Author
Hamidon Bin Basri
- Function : Author
Law Wan Chung
- Function : Author
Aznita Binti Ibrahim
- Function : Author
Khairul Azmi Ibrahim
- Function : Author
Irene Looi
- Function : Author
Wee Yong Tan
- Function : Author
Nafisah Wan Yahya
- Function : Author
Stanislav Groppa
- Function : Author
Pavel Leahu
- Function : Author
Amal Al Hashmi
- Function : Author
Yahia Zakaria Imam
- Function : Author
Naveed Akhtar
- Function : Author
Maria Carissa Pineda-Franks
- Function : Author
Christian Oliver Co
- Function : Author
Dmitriy Kandyba
- Function : Author
Adel Alhazzani
- Function : Author
Hosam Al-Jehani
- Function : Author
Carol Huilian Tham
- Function : Author
Marlie Jane Mamauag
- Function : Author
Narayanaswamy Venketasubramanian
- Function : Author
Chih-Hao Chen
- Function : Author
Sung-Chun Tang
- Function : Author
Anchalee Churojana
- Function : Author
Esref Akil
- Function : Author
Özlem Aykaç
- Function : Author
Atilla Ozcan Ozdemir
- Function : Author
Semih Giray
- Function : Author
Syed Irteza Hussain
- Function : Author
Seby John
- Function : Author
Huynh Le Vu
- Function : Author
Anh Duc Tran
- Function : Author
Huy Hoang Nguyen
- Function : Author
Thong Nhu Pham
- Function : Author
Thang Huy Nguyen
- Function : Author
Trung Quoc Nguyen
- Function : Author
Thomas Gattringer
- Function : Author
Christian Enzinger
- Function : Author
Monika Killer-Oberpfalzer
- Function : Author
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- ORCID : 0000-0001-5572-7694
Flavio Bellante
- Function : Author
Sofie de Blauwe
- Function : Author
Geert Vanhooren
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Sylvie de Raedt
- Function : Author
Anne Dusart
- Function : Author
Robin Lemmens
- Function : Author
Noemie Ligot
- Function : Author
Matthieu Pierre Rutgers
- Function : Author
Laetitia Yperzeele
- Function : Author
Filip Alexiev
- Function : Author
Teodora Sakelarova
- Function : Author
Marina Roje Bedeković
- Function : Author
Hrvoje Budincevic
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Igor Cindric
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Zlatko Hucika
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David Ozretic
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Majda Seferovic Saric
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František Pfeifer
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Igor Karpowic
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David Cernik
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Martin Sramek
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Miroslav Skoda
- Function : Author
Helena Hlavacova
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Lukas Klecka
- Function : Author
Martin Koutny
- Function : Author
Daniel Vaclavik
- Function : Author
Ondrej Skoda
- Function : Author
Jan Fiksa
- Function : Author
Katerina Hanelova
- Function : Author
Miroslava Nevsimalova
- Function : Author
Robert Rezek
- Function : Author
Petr Prochazka
- Function : Author
Gabriela Krejstova
- Function : Author
Jiri Neumann
- Function : Author
Marta Vachova
- Function : Author
Henryk Brzezanski
- Function : Author
David Hlinovsky
- Function : Author
Dusan Tenora
- Function : Author
Rene Jura
- Function : Author
Lubomír Jurák
- Function : Author
Jan Novak
- Function : Author
Ales Novak
- Function : Author
Zdenek Topinka
- Function : Author
Petr Fibrich
- Function : Author
Helena Sobolova
- Function : Author
Ondrej Volny
- Function : Author
Hanne Krarup Christensen
- Function : Author
Nicolas Drenck
- Function : Author
Helle Klingenberg Iversen
- Function : Author
Claus Simonsen
- Function : Author
Thomas Clement Truelsen
- Function : Author
Troels Wienecke
- Function : Author
Riina Vibo
- Function : Author
Katrin Gross-Paju
- Function : Author
Toomas Toomsoo
- Function : Author
Katrin Antsov
- Function : Author
Charlotte Cordonnier
- Function : Author
Maria Dan
- Function : Author
Jean-Marc Faucheux
- Function : Author
Laura Mechtouff
- Function : Author
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Omer Eker
- Function : Author
Emilie Lesaine
- Function : Author
Basile Ondze
- Function : Author
Roxane Peres
- Function : Author
Fernando Pico
- Function : Author
Michel Piotin
- Function : Author
- PersonId : 767048
- ORCID : 0000-0002-1354-4328
- IdRef : 104505605
Raoul Pop
- Function : Author
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- ORCID : 0000-0003-4417-1496
Francois Rouanet
- Function : Author
Tatuli Gubeladze
- Function : Author
Mirza Khinikadze
- Function : Author
Nino Lobjanidze
- Function : Author
Alexander Tsiskaridze
- Function : Author
Simon Nagel
- Function : Author
Peter Arthur Ringleb
- Function : Author
Michael Rosenkranz
- Function : Author
Holger Schmidt
- Function : Author
Annahita Sedghi
- Function : Author
Timo Siepmann
- Function : Author
Kristina Szabo
- Function : Author
Götz Thomalla
- Function : Author
Lina Palaiodimou
- Function : Author
Dimitrios Sagris
- Function : Author
Odysseas Kargiotis
- Function : Author
Peter Klivenyi
- Function : Author
Laszlo Szapary
- Function : Author
Gabor Tarkanyi
- Function : Author
Alessandro Adami
- Function : Author
Fabio Bandini
- Function : Author
Paolo Calabresi
- Function : Author
Giovanni Frisullo
- Function : Author
Leonardo Renieri
- Function : Author
Davide Sangalli
- Function : Author
Anne Pirson
- Function : Author
Maarten Uyttenboogaart
- Function : Author
Ido van den Wijngaard
- Function : Author
Espen Saxhaug Kristoffersen
- Function : Author
Waldemar Brola
- Function : Author
- PersonId : 794281
- ORCID : 0000-0002-7955-3454
Małgorzata Fudala
- Function : Author
Ewa Horoch-Lyszczarek
- Function : Author
Michal Karlinski
- Function : Author
Radoslaw Kazmierski
- Function : Author
Pawel Kram
- Function : Author
Marcin Rogoziewicz
- Function : Author
Rafal Kaczorowski
- Function : Author
Piotr Luchowski
- Function : Author
Halina Sienkiewicz-Jarosz
- Function : Author
Piotr Sobolewski
- Function : Author
Waldemar Fryze
- Function : Author
Anna Wisniewska
- Function : Author
Malgorzata Wiszniewska
- Function : Author
Patricia Ferreira
- Function : Author
Paulo Ferreira
- Function : Author
- PersonId : 756547
- ORCID : 0000-0001-6794-7192
Luisa Fonseca
- Function : Author
João Pedro Marto
- Function : Author
Teresa Pinho E Melo
- Function : Author
Ana Paiva Nunes
- Function : Author
Miguel Rodrigues
- Function : Author
- PersonId : 791106
- ORCID : 0000-0003-3958-9919
Vítor Tedim Cruz
- Function : Author
Cristian Falup-Pecurariu
- Function : Author
Georgi Krastev
- Function : Author
Miroslav Mako
- Function : Author
María Alonso de Leciñana
- Function : Author
Juan Arenillas
- Function : Author
Oscar Ayo-Martin
- Function : Author
Antonio Cruz Culebras
- Function : Author
Exuperio Diez Tejedor
- Function : Author
Joan Montaner
- Function : Author
Soledad Pérez-Sánchez
- Function : Author
Miguel Angel Tola Arribas
- Function : Author
Alejandro Rodriguez Vasquez
- Function : Author
Michael Mayza
- Function : Author
Gianmarco Bernava
- Function : Author
Alex Brehm
- Function : Author
Paolo Machi
- Function : Author
Urs Fischer
- Function : Author
- PersonId : 770350
- ORCID : 0000-0003-0521-4051
Jan Gralla
- Function : Author
Patrik Michel
- Function : Author
Marios-Nikos Psychogios
- Function : Author
Davide Strambo
- Function : Author
Soma Banerjee
- Function : Author
Kailash Krishnan
- Function : Author
Joseph Kwan
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Asif Butt
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Luciana Catanese
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Andrew Demchuk
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Thalia Field
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Jennifer Haynes
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Michael Hill
- Function : Author
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- ORCID : 0000-0002-5293-9365
Houman Khosravani
- Function : Author
Ariane Mackey
- Function : Author
Aleksandra Pikula
- Function : Author
Gustavo Saposnik
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Courtney Anne Scott
- Function : Author
Ashkan Shoamanesh
- Function : Author
Ashfaq Shuaib
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Samuel Yip
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Miguel Barboza
- Function : Author
Jose Domingo Barrientos
- Function : Author
Ligia Ibeth Portillo Rivera
- Function : Author
Fernando Gongora-Rivera
- Function : Author
Nelson Novarro-Escudero
- Function : Author
Anmylene Blanco
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Michael Abraham
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Diana Alsbrook
- Function : Author
Dorothea Altschul
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Anthony Alvarado-Ortiz
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Ivo Bach
- Function : Author
Aamir Badruddin
- Function : Author
Nobl Barazangi
- Function : Author
Charmaine Brereton
- Function : Author
Alicia Castonguay
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Seemant Chaturvedi
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Saqib Chaudry
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Hana Choe
- Function : Author
Jae Choi
- Function : Author
Sushrut Dharmadhikari
- Function : Author
Kinjal Desai
- Function : Author
Thomas Devlin
- Function : Author
Vinodh Doss
- Function : Author
Randall Edgell
- Function : Author
Mark Etherton
- Function : Author
Mudassir Farooqui
- Function : Author
Don Frei
- Function : Author
Dheeraj Gandhi
- Function : Author
Mikayel Grigoryan
- Function : Author
Rishi Gupta
- Function : Author
Ameer Hassan
- Function : Author
Johanna Helenius
- Function : Author
Artem Kaliaev
- Function : Author
Ritesh Kaushal
- Function : Author
Priyank Khandelwal
- Function : Author
Naim Khoury
- Function : Author
Benny Kim
- Function : Author
Dawn Kleindorfer
- Function : Author
Feliks Koyfman
- Function : Author
Vivien Lee
- Function : Author
Lester Leung
- Function : Author
Guillermo Linares
- Function : Author
Italo Linfante
- Function : Author
Helmi Lutsep
- Function : Author
Lisa Macdougall
- Function : Author
Shailesh Male
- Function : Author
Amer Malik
- Function : Author
Hesham Masoud
- Function : Author
Molly Mcdermott
- Function : Author
Brijesh Mehta
- Function : Author
Jiangyong Min
- Function : Author
Manoj Mittal
- Function : Author
Jane Morris
- Function : Author
Sumeet Multani
- Function : Author
Fadi Nahab
- Function : Author
Krishna Nalleballe
- Function : Author
Claude Nguyen
- Function : Author
Roberta Novakovic-White
- Function : Author
Santiago Ortega-Gutierrez
- Function : Author
Rahul Rahangdale
- Function : Author
Pankajavalli Ramakrishnan
- Function : Author
Jose Rafael Romero
- Function : Author
Natalia Rost
- Function : Author
Aaron Rothstein
- Function : Author
Sean Ruland
- Function : Author
Ruchir Shah
- Function : Author
Malveeka Sharma
- Function : Author
Brian Silver
- Function : Author
Marc Simmons
- Function : Author
Abhishek Singh
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Amy Starosciak
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Sheryl Strasser
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Viktor Szeder
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Mohamed Teleb
- Function : Author
Jenny Tsai
- Function : Author
Barbara Voetsch
- Function : Author
Oscar Balaguera
- Function : Author
Virginia Pujol Lereis
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Adriana Luraschi
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Marcele Schettini Almeida
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Fabricio Buchdid Cardoso
- Function : Author
Adriana Conforto
- Function : Author
Leonardo de Deus Silva
- Function : Author
Luidia Varrone Giacomini
- Function : Author
Fabricio Oliveira Lima
- Function : Author
Alexandre Longo
- Function : Author
Pedro Magalhães
- Function : Author
Rodrigo Targa Martins
- Function : Author
Francisco Mont'Alverne
- Function : Author
Daissy Liliana Mora Cuervo
- Function : Author
Leticia Costa Rebello
- Function : Author
Lenise Valler
- Function : Author
Viviane Flumignan Zetola
- Function : Author
Pablo Lavados
- Function : Author
Victor Navia
- Function : Author
Verónica Olavarría
- Function : Author
Juan Manuel Almeida Toro
- Function : Author
Pablo Felipe Ricardo Amaya
- Function : Author
Hernan Bayona
- Function : Author
Angel Corredor
- Function : Author
Carlos Eduardo Rivera Ordonez
- Function : Author
Diana Katherine Mantilla Barbosa
- Function : Author
Osvaldo Lara
- Function : Author
Mauricio Patiño
- Function : Author
Luis Fernando Diaz Escobar
- Function : Author
Donoband Edson Dejesus Melgarejo Fariña
- Function : Author
Analia Cardozo Villamayor
- Function : Author
Adolfo Javier Zelaya Zarza
- Function : Author
Danny Moises Barrientos Iman
- Function : Author
Liliana Rodriguez Kadota
- Function : Author
Bruce Campbell
- Function : Author
Graeme Hankey
- Function : Author
Casey Hair
- Function : Author
Timothy Kleinig
- Function : Author
Alice Ma
- Function : Author
Rodrigo Tomazini Martins
- Function : Author
Ramesh Sahathevan
- Function : Author
Vincent Thijs
- Function : Author
Daniel Salazar
- Function : Author
Teddy Yuan-Hao Wu
- Function : Author
Diogo Haussen
- Function : Author
David Liebeskind
- Function : Author
- PersonId : 786400
- ORCID : 0000-0002-5109-8736
Dileep Yavagal
- Function : Author
Tudor Jovin
- Function : Author
Osama Zaidat
- Function : Author
- PersonId : 786403
- ORCID : 0000-0003-4881-4698
Thanh Nguyen
- Function : Author
Pedro S.C. Magalhães
- Function : Author
Abstract
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.