TY - JOUR
T1 - Global impact of the COVID-19 pandemic on subarachnoid haemorrhage hospitalisations, aneurysm treatment and in-hospital mortality
T2 - 1-year follow-up
AU - SVIN Global COVID-19 SAH Registry
AU - Nguyen, Thanh N.
AU - Qureshi, Muhammad M.
AU - Klein, Piers
AU - Yamagami, Hiroshi
AU - Mikulik, Robert
AU - Etminan, Nima
AU - Abdalkader, Mohamad
AU - Mansour, Ossama Yassin
AU - Czlonkowska, Anna
AU - Lo, Hannah
AU - Sathya, Anvitha
AU - Demeestere, Jelle
AU - Tsivgoulis, Georgios
AU - Sakai, Nobuyuki
AU - Sedova, Petra
AU - Kristoffersen, Espen Saxhaug
AU - Mohammaden, Mahmoud
AU - Lereis, Virginia Pujol
AU - Scollo, Sergio Daniel
AU - Ma, Alice
AU - Rahman, Aminur
AU - Bonnet, Thomas
AU - Cortier, Jeroen
AU - Raedt, Sylvie De
AU - Lemmens, Robin
AU - Ligot, Noemie
AU - Hidalgo, Raquel C.T.
AU - Cuervo, Daissy Liliana Mora
AU - De Oliveira Neves, Luciana
AU - Rezende, Marco Tulio Salles
AU - Santiago, Igor Bessa
AU - Sirakov, Alexander
AU - Sirakov, Stanimir
AU - Cora, Elena Adela
AU - Kelly, Michael E.
AU - Lavoie, Pascale
AU - Peeling, Lissa
AU - Pikula, Aleksandra
AU - Rivera, Rodrigo
AU - Chen, Hui Sheng
AU - Chen, Yimin
AU - Fang, Hongliang
AU - Bedekovic, Marina Roje
AU - Budincevic, Hrvoje
AU - Strossmayer, J. J.
AU - Čabal, Martin
AU - Hrabanovska, Emanuela
AU - Jurak, Lubomir
AU - Kadlckova, Jana
AU - Kan, Peter T.
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/10/1
Y1 - 2022/10/1
N2 - Background Prior studies indicated a decrease in the incidences of aneurysmal subarachnoid haemorrhage (aSAH) during the early stages of the COVID-19 pandemic. We evaluated differences in the incidence, severity of aSAH presentation, and ruptured aneurysm treatment modality during the first year of the COVID-19 pandemic compared with the preceding year. Methods We conducted a cross-sectional study including 49 countries and 187 centres. We recorded volumes for COVID-19 hospitalisations, aSAH hospitalisations, Hunt-Hess grade, coiling, clipping and aSAH in-hospital mortality. Diagnoses were identified by International Classification of Diseases, 10th Revision, codes or stroke databases from January 2019 to May 2021. Results Over the study period, there were 16 247 aSAH admissions, 344 491 COVID-19 admissions, 8300 ruptured aneurysm coiling and 4240 ruptured aneurysm clipping procedures. Declines were observed in aSAH admissions (-6.4% (95% CI-7.0% to-5.8%), p=0.0001) during the first year of the pandemic compared with the prior year, most pronounced in high-volume SAH and high-volume COVID-19 hospitals. There was a trend towards a decline in mild and moderate presentations of subarachnoid haemorrhage (SAH) (mild:-5% (95% CI-5.9% to-4.3%), p=0.06; moderate:-8.3% (95% CI-10.2% to-6.7%), p=0.06) but no difference in higher SAH severity. The ruptured aneurysm clipping rate remained unchanged (30.7% vs 31.2%, p=0.58), whereas ruptured aneurysm coiling increased (53.97% vs 56.5%, p=0.009). There was no difference in aSAH in-hospital mortality rate (19.1% vs 20.1%, p=0.12). Conclusion During the first year of the pandemic, there was a decrease in aSAH admissions volume, driven by a decrease in mild to moderate presentation of aSAH. There was an increase in the ruptured aneurysm coiling rate but neither change in the ruptured aneurysm clipping rate nor change in aSAH in-hospital mortality. Trial registration number NCT04934020.
AB - Background Prior studies indicated a decrease in the incidences of aneurysmal subarachnoid haemorrhage (aSAH) during the early stages of the COVID-19 pandemic. We evaluated differences in the incidence, severity of aSAH presentation, and ruptured aneurysm treatment modality during the first year of the COVID-19 pandemic compared with the preceding year. Methods We conducted a cross-sectional study including 49 countries and 187 centres. We recorded volumes for COVID-19 hospitalisations, aSAH hospitalisations, Hunt-Hess grade, coiling, clipping and aSAH in-hospital mortality. Diagnoses were identified by International Classification of Diseases, 10th Revision, codes or stroke databases from January 2019 to May 2021. Results Over the study period, there were 16 247 aSAH admissions, 344 491 COVID-19 admissions, 8300 ruptured aneurysm coiling and 4240 ruptured aneurysm clipping procedures. Declines were observed in aSAH admissions (-6.4% (95% CI-7.0% to-5.8%), p=0.0001) during the first year of the pandemic compared with the prior year, most pronounced in high-volume SAH and high-volume COVID-19 hospitals. There was a trend towards a decline in mild and moderate presentations of subarachnoid haemorrhage (SAH) (mild:-5% (95% CI-5.9% to-4.3%), p=0.06; moderate:-8.3% (95% CI-10.2% to-6.7%), p=0.06) but no difference in higher SAH severity. The ruptured aneurysm clipping rate remained unchanged (30.7% vs 31.2%, p=0.58), whereas ruptured aneurysm coiling increased (53.97% vs 56.5%, p=0.009). There was no difference in aSAH in-hospital mortality rate (19.1% vs 20.1%, p=0.12). Conclusion During the first year of the pandemic, there was a decrease in aSAH admissions volume, driven by a decrease in mild to moderate presentation of aSAH. There was an increase in the ruptured aneurysm coiling rate but neither change in the ruptured aneurysm clipping rate nor change in aSAH in-hospital mortality. Trial registration number NCT04934020.
KW - CEREBROVASCULAR DISEASE
KW - COVID-19
KW - SUBARACHNOID HAEMORRHAGE
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U2 - 10.1136/jnnp-2022-329200
DO - 10.1136/jnnp-2022-329200
M3 - Article
C2 - 35902229
AN - SCOPUS:85134306667
SN - 0022-3050
VL - 93
SP - 1028
EP - 1038
JO - Journal of Neurology, Neurosurgery and Psychiatry
JF - Journal of Neurology, Neurosurgery and Psychiatry
IS - 10
ER -