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Global Impact of COVID-19 on Stroke Care and IV Thrombolysis

Raul Nogueira 1 Muhammad Qureshi 2 Mohamad Abdalkader 2 Sheila Ouriques Martins Hiroshi Yamagami Zhongming Qiu Ossama Yassin Mansour Anvitha Sathya Anna Czlonkowska Georgios Tsivgoulis Diana Aguiar de Sousa Jelle Demeestere Robert Mikulik Peter Vanacker James Siegler Janika Kõrv Jose Biller Conrad Liang Navdeep Sangha Alicia Zha Alexandra Czap Christine Anne Holmstedt Tanya Turan 2 George Ntaios Konark Malhotra Ashis Tayal Aaron Loochtan Annamarei Ranta Eva Mistry Anne Alexandrov David Huang Shadi Yaghi Eytan Raz Sunil Sheth Mahmoud Mohammaden 1 Michael Frankel 1 Eric Guemekane Bila Lamou Hany Aref Ahmed Elbassiouny Farouk Hassan Tarek Menecie Wessam Mustafa Hossam Shokri Tamer Roushdy Fred Sarfo Tolulope Oyetunde Alabi Babawale Arabambi Ernest Nwazor Taofiki Ajao Sunmonu Kolawole Wahab Joseph Yaria Haytham Hussein Mohammed Philip Adebayo Anis Riahi Samia Ben Sassi Lenon Gwaunza Gift Wilson Ngwende David Sahakyan Aminur Rahman Zhibing Ai Fanghui Bai Zhenhui Duan Yonggang Hao Wenguo Huang Guangwen Li Wei Li Ganzhe Liu Jun Luo Xianjin Shang Yi Sui Ling Tian Hongbin Wen Bo Wu Yuying Yan Zhengzhou Yuan Hao Zhang Jun Zhang Wenlong Zhao Wenjie Zi Thomas Leung Chandril Chugh 3, 4 Vikram Huded Bindu Menon Jeyaraj Durai Pandian Pn Sylaja Fritz Sumantri Usman Mehdi Farhoudi Elyar Sadeghi Hokmabadi Anat Horev Anna Reznik Rotem Sivan Hoffmann Nobuyuki Ohara Nobuyuki Sakai Daisuke Watanabe Ryoo Yamamoto Ryosuke Doijiri Naoki Tokuda Takehiro Yamada Tadashi Terasaki Yukako Yazawa Takeshi Uwatoko Tomohisa Dembo Hisao Shimizu Yuri Sugiura Fumio Miyashita Hiroki Fukuda Kosuke Miyake Junsuke Shimbo Yusuke Sugimura Yoshiki Yagita Yohei Takenobu Yuji Matsumaru Satoshi Yamada Ryuhei Kono Takuya Kanamaru Hidekazu Yamazaki Manabu Sakaguchi Kenichi Todo Nobuaki Yamamoto Kazutaka Sonoda Tomoko Yoshida Hiroyuki Hashimoto Ichiro Nakahara Aida Kondybayeva Kamila Faizullina Saltanat Kamenova Murat Zhanuzakov Jang-Hyun Baek Yangha Hwang Jin Soo Lee Si Baek Lee Jusun Moon Hyungjong Park Jung Hwa Seo Kwon-Duk Seo Sung Il Sohn Chang Jun Young Rechdi Ahdab Wan Asyraf Wan Zaidi Zariah Abdul Aziz Hamidon Bin Basri Law Wan Chung Aznita Binti Ibrahim Khairul Azmi Ibrahim Irene Looi Wee Yong Tan Nafisah Wan Yahya Stanislav Groppa Pavel Leahu Amal Al Hashmi Yahia Zakaria Imam Naveed Akhtar Maria Carissa Pineda-Franks Christian Oliver Co Dmitriy Kandyba Adel Alhazzani Hosam Al-Jehani Carol Huilian Tham Marlie Jane Mamauag Narayanaswamy Venketasubramanian Chih-Hao Chen Sung-Chun Tang Anchalee Churojana Esref Akil Özlem Aykaç Atilla Ozcan Ozdemir Semih Giray Syed Irteza Hussain Seby John Huynh Le Vu Anh Duc Tran Huy Hoang Nguyen Thong Nhu Pham Thang Huy Nguyen Trung Quoc Nguyen Thomas Gattringer Christian Enzinger Monika Killer-Oberpfalzer Flavio Bellante Sofie de Blauwe Geert Vanhooren Sylvie de Raedt Anne Dusart Robin Lemmens Noemie Ligot Matthieu Pierre Rutgers Laetitia Yperzeele Filip Alexiev Teodora Sakelarova Marina Roje Bedeković Hrvoje Budincevic Igor Cindric Zlatko Hucika David Ozretic Majda Seferovic Saric František Pfeifer Igor Karpowic David Cernik Martin Sramek Miroslav Skoda Helena Hlavacova Lukas Klecka Martin Koutny Daniel Vaclavik Ondrej Skoda Jan Fiksa Katerina Hanelova Miroslava Nevsimalova Robert Rezek Petr Prochazka Gabriela Krejstova Jiri Neumann Marta Vachova Henryk Brzezanski David Hlinovsky Dusan Tenora Rene Jura Lubomír Jurák Jan Novak Ales Novak Zdenek Topinka Petr Fibrich Helena Sobolova Ondrej Volny Hanne Krarup Christensen Nicolas Drenck Helle Klingenberg Iversen Claus Simonsen Thomas Clement Truelsen Troels Wienecke Riina Vibo Katrin Gross-Paju Toomas Toomsoo Katrin Antsov Francois Caparros 3 Charlotte Cordonnier Maria Dan Jean-Marc Faucheux Laura Mechtouff Omer Eker Emilie Lesaine Basile Ondze Roxane Peres Fernando Pico Michel Piotin Raoul Pop Francois Rouanet Tatuli Gubeladze Mirza Khinikadze Nino Lobjanidze Alexander Tsiskaridze Simon Nagel Peter Arthur Ringleb Michael Rosenkranz Holger Schmidt Annahita Sedghi Timo Siepmann Kristina Szabo Götz Thomalla Lina Palaiodimou Dimitrios Sagris Odysseas Kargiotis Peter Klivenyi Laszlo Szapary Gabor Tarkanyi Alessandro Adami Fabio Bandini Paolo Calabresi Giovanni Frisullo Leonardo Renieri Davide Sangalli Anne Pirson Maarten Uyttenboogaart Ido van den Wijngaard Espen Saxhaug Kristoffersen Waldemar Brola Małgorzata Fudala Ewa Horoch-Lyszczarek Michal Karlinski Radoslaw Kazmierski Pawel Kram Marcin Rogoziewicz Rafal Kaczorowski Piotr Luchowski Halina Sienkiewicz-Jarosz Piotr Sobolewski Waldemar Fryze Anna Wisniewska Malgorzata Wiszniewska Patricia Ferreira Paulo Ferreira Luisa Fonseca João Pedro Marto Teresa Pinho E Melo Ana Paiva Nunes Miguel Rodrigues Vítor Tedim Cruz Cristian Falup-Pecurariu Georgi Krastev Miroslav Mako María Alonso de Leciñana Juan Arenillas Oscar Ayo-Martin Antonio Cruz Culebras Exuperio Diez Tejedor Joan Montaner Soledad Pérez-Sánchez Miguel Angel Tola Arribas Alejandro Rodriguez Vasquez Michael Mayza Gianmarco Bernava Alex Brehm Paolo Machi Urs Fischer Jan Gralla Patrik Michel Marios-Nikos Psychogios Davide Strambo Soma Banerjee Kailash Krishnan Joseph Kwan Asif Butt Luciana Catanese Andrew Demchuk Thalia Field Jennifer Haynes Michael Hill Houman Khosravani Ariane Mackey Aleksandra Pikula Gustavo Saposnik Courtney Anne Scott Ashkan Shoamanesh Ashfaq Shuaib Samuel Yip Miguel Barboza Jose Domingo Barrientos Ligia Ibeth Portillo Rivera Fernando Gongora-Rivera Nelson Novarro-Escudero Anmylene Blanco Michael Abraham Diana Alsbrook Dorothea Altschul Anthony Alvarado-Ortiz Ivo Bach Aamir Badruddin Nobl Barazangi Charmaine Brereton Alicia Castonguay Seemant Chaturvedi Saqib Chaudry Hana Choe Jae Choi Sushrut Dharmadhikari Kinjal Desai Thomas Devlin Vinodh Doss Randall Edgell Mark Etherton Mudassir Farooqui Don Frei Dheeraj Gandhi Mikayel Grigoryan Rishi Gupta Ameer Hassan Johanna Helenius Artem Kaliaev Ritesh Kaushal Priyank Khandelwal Ayaz Khawaja 2 Naim Khoury Benny Kim Dawn Kleindorfer Feliks Koyfman Vivien Lee Lester Leung Guillermo Linares Italo Linfante Helmi Lutsep Lisa Macdougall Shailesh Male Amer Malik Hesham Masoud Molly Mcdermott Brijesh Mehta Jiangyong Min Manoj Mittal Jane Morris Sumeet Multani Fadi Nahab Krishna Nalleballe Claude Nguyen Roberta Novakovic-White Santiago Ortega-Gutierrez Rahul Rahangdale Pankajavalli Ramakrishnan Jose Rafael Romero Natalia Rost Aaron Rothstein Sean Ruland Ruchir Shah Malveeka Sharma Brian Silver Marc Simmons Abhishek Singh Amy Starosciak Sheryl Strasser Viktor Szeder Mohamed Teleb Jenny Tsai Barbara Voetsch Oscar Balaguera Virginia Pujol Lereis Adriana Luraschi Marcele Schettini Almeida Fabricio Buchdid Cardoso Adriana Conforto Leonardo de Deus Silva Luidia Varrone Giacomini Fabricio Oliveira Lima Alexandre Longo Pedro Magalhães Rodrigo Targa Martins Francisco Mont'Alverne Daissy Liliana Mora Cuervo Leticia Costa Rebello Lenise Valler Viviane Flumignan Zetola Pablo Lavados Victor Navia Verónica Olavarría Juan Manuel Almeida Toro Pablo Felipe Ricardo Amaya Hernan Bayona Angel Corredor Carlos Eduardo Rivera Ordonez Diana Katherine Mantilla Barbosa Osvaldo Lara Mauricio Patiño Luis Fernando Diaz Escobar Donoband Edson Dejesus Melgarejo Fariña Analia Cardozo Villamayor Adolfo Javier Zelaya Zarza Danny Moises Barrientos Iman Liliana Rodriguez Kadota Bruce Campbell Graeme Hankey Casey Hair Timothy Kleinig Alice Ma Rodrigo Tomazini Martins Ramesh Sahathevan Vincent Thijs Daniel Salazar Teddy Yuan-Hao Wu Diogo Haussen David Liebeskind Dileep Yavagal Tudor Jovin Osama Zaidat Thanh Nguyen Pedro S.C. Magalhães
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.
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https://www.hal.inserm.fr/inserm-03356024
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Submitted on : Monday, September 27, 2021 - 4:28:41 PM
Last modification on : Tuesday, September 28, 2021 - 3:15:16 AM

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Raul Nogueira, Muhammad Qureshi, Mohamad Abdalkader, Sheila Ouriques Martins, Hiroshi Yamagami, et al.. Global Impact of COVID-19 on Stroke Care and IV Thrombolysis. Neurology, American Academy of Neurology, 2021, 96 (23), pp.e2824-e2838. ⟨10.1212/WNL.0000000000011885⟩. ⟨inserm-03356024⟩

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