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

Thanh N Nguyen; Diogo C Haussen; Muhammad M Qureshi; Hiroshi Yamagami; Toshiyuki Fujinaka; Ossama Y Mansour; Mohamad Abdalkader; Michael Frankel; Zhongming Qiu; Allan Taylor; Pedro Lylyk; Omer F Eker; Laura Mechtouff; Michel Piotin; Fabricio Oliveira Lima; Francisco Mont'Alverne; Wazim Izzath; Nobuyuki Sakai; Mahmoud Mohammaden; Alhamza R Al-Bayati; Leonardo Renieri; Salvatore Mangiafico; David Ozretic; Vanessa Chalumeau; Saima Ahmad; Umair Rashid; Syed Irteza Hussain; Seby John; Emma Griffin; John Thornton; Jose Antonio Fiorot; Rodrigo Rivera; Nadia Hammami; Anna M Cervantes-Arslanian; Hormuzdiyar H Dasenbrock; Huynh Le Vu; Viet Quy Nguyen; Steven Hetts; Romain Bourcier; Romain Guile; Melanie Walker; Malveeka Sharma; Don Frei; Pascal Jabbour; Nabeel Herial; Fawaz Al-Mufti; Atilla Ozcan Ozdemir; Ozlem Aykac; Dheeraj Gandhi; Chandril Chugh; Charles Matouk; 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; Adrienne Weeks; Elena A Cora; Rotem Sivan-Hoffmann; Roberto Crosa; Markus Möhlenbruch; Simon Nagel; Hosam Al-Jehani; Sunil A Sheth; Victor S Lopez Rivera; James E Siegler; Achmad Fidaus Sani; Ajit S Puri; Anna Luisa Kuhn; Gianmarco Bernava; Paolo Machi; Daniel G Abud; Octavio M Pontes-Neto; Ajay K Wakhloo; Barbara Voetsch; Eytan Raz; Shadi Yaghi; Brijesh P Mehta; Naoto Kimura; Mamoru Murakami; Jin Soo Lee; Ji Man Hong; Robert Fahed; Gregory Walker; Eiji Hagashi; Steve M Cordina; Hong Gee Roh; Ken Wong; Juan F Arenillas; Mario Martinez-Galdamez; Jordi Blasco; Alejandro Rodriguez Vasquez; Luisa Fonseca; M Luis Silva; Teddy Y Wu; Simon John; Alex Brehm; Marios Psychogios; William J Mack; Matthew Tenser; Tatemi Todaka; Miki Fujimura; Roberta Novakovic; Jun Deguchi; Yuri Sugiura; Hiroshi Tokimura; Rakesh Khatri; Michael Kelly; Lissa Peeling; Yuichi Murayama; Hugh Stephen Winters; Johnny Wong; Mohamed Teleb; Jeremy Payne; Hiroki Fukuda; Kosuke Miyake; Junsuke Shimbo; Yusuke Sugimura; Masaaki Uno; Yohei Takenobu; Yuji Matsumaru; Satoshi Yamada; Ryuhei Kono; Takuya Kanamaru; Masafumi Morimoto; Junichi Iida; Vasu Saini; Dileep Yavagal; Saif Bushnaq; Wenguo Huang; Italo Linfante; Jawad Kirmani; David S Liebeskind; Viktor Szeder; Ruchir Shah; Thomas G Devlin; Lee Birnbaum; Jun Luo; Anchalee Churojana; Hesham E Masoud; Carlos Ynigo Lopez; Brendan Steinfort; Alice Ma; Ameer E Hassan; Amal Al Hashmi; 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; Middle East North Africa Stroke In

doi:10.1136/svn-2020-000695

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

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

Thanh N Nguyen, Diogo C Haussen, Muhammad M Qureshi, Hiroshi Yamagami, Toshiyuki Fujinaka, Ossama Y Mansour, Mohamad Abdalkader, Michael Frankel, Zhongming Qiu, Allan Taylor, …

Stroke and vascular neurology, Vol.6(4), pp.542-552

01/12/2021

DOI: https://doi.org/10.1136/svn-2020-000695

PMID: 33771936

Abstract

BackgroundDuring 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.MethodsWe 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.FindingsThere 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.InterpretationThere 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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Title: Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic
Creators - without role: Thanh N Nguyen - Boston Medical Center
Diogo C Haussen - Grady Memorial Hospital
Muhammad M Qureshi - Boston University
Hiroshi Yamagami - Osaka National Hospital
Toshiyuki Fujinaka - Osaka National Hospital
Ossama Y Mansour - Alexandria University
Mohamad Abdalkader - Boston Medical Center
Michael Frankel - Grady Memorial Hospital
Zhongming Qiu - Xinqiao Hospital
Allan Taylor - University of Cape Town
Pedro Lylyk - Neurosurgery, Interventional Neuroradiology, Clinica La Sagrada Familia, Buenos Aires, Argentina
Omer F Eker - Hospices Civils de Lyon
Laura Mechtouff - Hospices Civils de Lyon
Michel Piotin - Fondation Ophtalmologique Adolphe de Rothschild
Fabricio Oliveira Lima - Hospital Geral de Fortaleza
Francisco Mont'Alverne - Hospital Geral de Fortaleza
Wazim Izzath - Nottingham University Hospitals NHS Trust
Nobuyuki Sakai - Kobe City Medical Center General Hospital
Mahmoud Mohammaden - Grady Memorial Hospital
Alhamza R Al-Bayati - Grady Memorial Hospital
Leonardo Renieri - Azienda Ospedaliero-Universitaria Careggi
Salvatore Mangiafico - Azienda Ospedaliero-Universitaria Careggi
David Ozretic - University Hospital Centre Zagreb
Vanessa Chalumeau - Bicêtre Hospital
Saima Ahmad - Lahore General Hospital
Umair Rashid - Lahore General Hospital
Syed Irteza Hussain - Cleveland Eye Clinic
Seby John - Cleveland Clinic
Emma Griffin - Beaumont Hospital
John Thornton - Beaumont Hospital
Jose Antonio Fiorot - Hospital Estadual Centra
Rodrigo Rivera - Instituto de Neurociencia Biomédica
Nadia Hammami - Interventional Neuroradiology, Institut National de Neurologie, Tunis, Tunisia
Anna M Cervantes-Arslanian - Boston Medical Center
Hormuzdiyar H Dasenbrock - Boston Medical Center
Huynh Le Vu - Hue Central Hospital
Viet Quy Nguyen - Hue Central Hospital
Steven Hetts - University of California, San Francisco
Romain Bourcier - Hôpital Laennec
Romain Guile - Hôpital Laennec
Melanie Walker - University of Washington
Malveeka Sharma - University of Washington
Don Frei - Swedish Medical Center
Pascal Jabbour - Thomas Jefferson University Hospital
Nabeel Herial - Thomas Jefferson University Hospital
Fawaz Al-Mufti - Westchester Medical Center
Atilla Ozcan Ozdemir - Eskişehir Osmangazi University
Ozlem Aykac - Eskişehir Osmangazi University
Dheeraj Gandhi - University of Maryland, Baltimore
Chandril Chugh - Max Super Speciality Hospital
Charles Matouk - Yale University
Pascale Lavoie - Centre Hospitalier Universitaire de Québec
Randall Edgell - Saint Louis University
Andre Beer-Furlan - Rush University Medical Center
Michael Chen - Rush University Medical Center
Monika Killer-Oberpfalzer - Paracelsus Medical University
Vitor Mendes Pereira - University of Toronto
Patrick Nicholson - University of Toronto
Vikram Huded - Mazumdar Shaw Medical Centre
Nobuyuki Ohara - Kobe City Medical Center General Hospital
Daisuke Watanabe - Katsushika Medical Center
Dong Hun Shin - Gachon University
Pedro SC Magalhaes - Hospital Municipal São José
Raghid Kikano - University Medical Center Rizk Hospital
Santiago Ortega-Gutierrez - University of Iowa Hospitals and Clinics
Mudassir Farooqui - University of Iowa Hospitals and Clinics
Amal Abou-Hamden - Royal Adelaide Hospital
Tatsuo Amano - Kyorin University
Ryoo Yamamoto - Kanagawa Cardiovascular and Respiratory Center
Adrienne Weeks - Dalhousie University
Elena A Cora - Dalhousie University
Rotem Sivan-Hoffmann - Rambam Health Care Campus
Roberto Crosa - Centro Uruguayo de Imagenología Molecular
Markus Möhlenbruch - University Hospital Heidelberg
Simon Nagel - University Hospital Heidelberg
Hosam Al-Jehani - King Fahd Hospital of the University
Sunil A Sheth - The University of Texas Health Science Center
Victor S Lopez Rivera - Neurology, University of Texas McGovern Medical School, Houston, Texas, USA
James E Siegler - Cooper University Hospital
Achmad Fidaus Sani - Airlangga University
Ajit S Puri - University of Massachusetts Chan Medical School
Anna Luisa Kuhn - University of Massachusetts Chan Medical School
Gianmarco Bernava - University Hospital of Geneva
Paolo Machi - University Hospital of Geneva
Daniel G Abud - Universidade de São Paulo
Octavio M Pontes-Neto - Universidade de São Paulo
Ajay K Wakhloo - Lahey Medical Center
Barbara Voetsch - Lahey Medical Center
Eytan Raz - NYU Langone Health
Shadi Yaghi - Neurology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, USA
Brijesh P Mehta - Neuroscience Institute
Naoto Kimura - Iwate Prefectural Central Hospital
Mamoru Murakami - Kyoto first Red Cross hospital
Jin Soo Lee - Ajou University Hospital
Ji Man Hong - Ajou University Hospital
Robert Fahed - University of Ottawa
Gregory Walker - University of Ottawa
Eiji Hagashi - Saga-Ken Medical Centre Koseikan
Steve M Cordina - University of South Alabama
Hong Gee Roh - Konkuk University
Ken Wong - Barts Health NHS Trust
Juan F Arenillas - Hospital Clínico Universitario de Valladolid
Mario Martinez-Galdamez - Interventional Neuroradiology, Hospital Clínico Universitario, Universidad de Valladolid, Valladolid, Spain
Jordi Blasco - Hospital Clínic de Barcelona
Alejandro Rodriguez Vasquez - Hospital Clínic de Barcelona
Luisa Fonseca - Stroke Unit, Department of Medicine, Centro Hospitalar Universitário de São João, Porto, Portugal
M Luis Silva - Neuroradiology, Centro Hospitalar Universitário de São João, Porto, Portugal
Teddy Y Wu - Neurology, Christchurch Hospital, Christchurch, New Zealand
Simon John - Neurosurgery, Christchurch Hospital, Christchurch, New Zealand
Alex Brehm - University Hospital of Basel
Marios Psychogios - University Hospital of Basel
William J Mack - Neurosurgery, University of Southern California, Los Angeles, California, USA
Matthew Tenser - Neurosurgery, University of Southern California, Los Angeles, California, USA
Tatemi Todaka - Japanese Red Cross Kumamoto Hospital
Miki Fujimura - Kohnan Hospital
Roberta Novakovic - Radiology, Neurology, UT Southwestern, Dallas, Texas, USA
Jun Deguchi - Nara City Hospital
Yuri Sugiura - Toyonaka Municipal Hospital
Hiroshi Tokimura - Kagoshima City Hospital
Rakesh Khatri - Texas Tech University System, Lubbock, Texas, USA
Michael Kelly - University of Saskatchewan
Lissa Peeling - University of Saskatchewan
Yuichi Murayama - Jikei University School of Medicine
Hugh Stephen Winters - Royal Prince Alfred Hospital
Johnny Wong - Royal Prince Alfred Hospital
Mohamed Teleb - Banner Desert Medical Center
Jeremy Payne - Banner Desert Medical Center
Hiroki Fukuda - Neurology, Japanese Red Cross Matsue Hospital, Shimane, Japan
Kosuke Miyake - Neurology, Shiroyama Hospital, Habikino, Osaka, Japan
Junsuke Shimbo - Niigata City General Hospital
Yusuke Sugimura - Neurology, Sugimura Hospital, Kumamoto, Japan
Masaaki Uno - Kawasaki Medical School
Yohei Takenobu - Osaka Red Cross Hospital
Yuji Matsumaru - University of Tsukuba
Satoshi Yamada - Saiseikai Central Hospital
Ryuhei Kono - Neurology, Kinikyo Chuo Hospital, Sapporo, Hokkaido, Japan
Takuya Kanamaru - NTT Medical Center
Masafumi Morimoto - Neurosurgery, Yokohama Shintoshi Neurosurgical Hospital, Yokohama, Japan
Junichi Iida - Osaka Prefectural Medical Center
Vasu Saini - University of Miami
Dileep Yavagal - University of Miami
Saif Bushnaq - Bon Secours Mercy Health
Wenguo Huang - Neurology, Maoming City Hospital, Guandong, China
Italo Linfante - Interventional Neuroradiology, Endovascular Neurosurgery, Miami Cardiac & Vascular Institute, Miami, Florida, USA
Jawad Kirmani - Hackensack Meridian Health
David S Liebeskind - University of California, Los Angeles
Viktor Szeder - University of California, Los Angeles
Ruchir Shah - University of Tennessee at Knoxville
Thomas G Devlin - University of Tennessee at Knoxville
Lee Birnbaum - Neurology, Neurosurgery, Radiology, University of Texas Health San Antonio, San Antonio, Texas, USA
Jun Luo - Neurology, Mianyang Hospital, Mianyang, Sichuan, China
Anchalee Churojana - Mahidol University
Hesham E Masoud - SUNY Upstate Medical University
Carlos Ynigo Lopez - SUNY Upstate Medical University
Brendan Steinfort - Royal North Shore Hospital
Alice Ma - Royal North Shore Hospital
Ameer E Hassan - The University of Texas Rio Grande Valley
Amal Al Hashmi - Khoula Hospital
Mollie McDermott - University of Michigan–Ann Arbor
Maxim Mokin - Neurosurgery, University of South Florida, Tampa, Florida, USA
Alex Chebl - Henry Ford Health System
Odysseas Kargiotis - Stroke Unit, Metropolitan Hospital, Piraeus, Greece
Georgios Tsivgoulis - National and Kapodistrian University of Athens
Jane G Morris - Neurology, Maine Medical Center, Portland, Maine, USA
Clifford J Eskey - Dartmouth–Hitchcock Medical Center
Jesse Thon - Cooper Medical School of Rowan University
Leticia Rebello - Hospital Universitário de Brasília
Dorothea Altschul - Neurointerventional Neurosurgery, The Valley Hospital, Ridgewood, New Jersey, USA
Oriana Cornett - St. Joseph’s University Medical Center
Varsha Singh - St. Joseph’s University Medical Center
Jeyaraj Pandian - Christian Medical College
Anirudh Kulkarni - Christian Medical College
Pablo M Lavados - Clínica Alemana
Veronica V Olavarria - Clínica Alemana
Kenichi Todo - Osaka University
Yuki Yamamoto - Tokushima University Hospital
Gisele Sampaio Silva - Universidade Federal de São Paulo
Serdar Geyik - Istanbul Aydin University, Istanbul, İstanbul, Turkey
Jasmine Johann - Radiology, Swedish Medical Center, Englewood, Colorado, USA
Sumeet Multani - Neurology, Bayhealth Medical Center, Dover, Delaware, USA
Artem Kaliaev - Boston Medical Center
Kazutaka Sonoda - Saiseikai Fukuoka General Hospital
Hiroyuki Hashimoto - Osaka Rosai Hospital
Adel Alhazzani - King Saud University
David Y Chung - Boston Medical Center
Stephan A Mayer - Westchester Medical Center
Johanna T Fifi - Mount Sinai Health System
Michael D Hill - University of Calgary
Hao Zhang - Zhejiang University
Zhengzhou Yuan - Affiliated Hospital of Southwest Medical University
Xianjin Shang - Wannan Medical College
Alicia C Castonguay - University of Toledo
Rishi Gupta - WellStar Health System
Tudor G Jovin - Cooper Medical School of Rowan University
Jean Raymond - Centre Hospitalier de l’Université de Montréal
Osama O Zaidat - Bon Secours Mercy Health
Raul G Nogueira - Emory University School of Medicine
Middle East North Africa Stroke In
Publication Details: Stroke and vascular neurology, Vol.6(4), pp.542-552
Identifiers: 9915203408331
Academic Unit: Imam Abdulrahman Bin Faisal University; King Saud University
Language: English
Resource Type: Journal article