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SurawanSurawanBoonyakarnkulChurojana, AnchaleeAnchaleeChurojanaAykac, OzlemOzlemAykacOzdemir, AtillaAtillaOzdemirBajrami, ArsidaArsidaBajramiSenadim, SongulSongulSenadimHussain, Syed IrtezaSyed IrtezaHussainJohn, SebySebyJohnBanerjee, SomaSomaBanerjeeKwan, JosephJosephKwanKrishnan, KailashKailashKrishnanLenthall, RobertRobertLenthallMatthews, AshokAshokMatthewsWong, KenKenWongZhang, LiqunLiqunZhangAltschul, DorotheaDorotheaAltschulAsif, Kaiz SKaiz SAsifBahiru, ZeelalemZeelalemBahiruBelow, KristineKristineBelowBiller, JoséJoséBillerRuland, SeanSeanRulandChaudry, Saqib ASaqib AChaudryChen, MichaelMichaelChenChebl, AlexAlexCheblCibulka, JackieJackieCibulkaCistrunk, LeonLeonCistrunkClark, JudithJudithClarkColasurdo, MarcoMarcoColasurdoCzap, AlexandraAlexandraCzapde Havenon, AdamAdamde HavenonD'Amato, SalvatoreSalvatoreD'AmatoDharmadhikari, SushrutSushrutDharmadhikariGrimmett, Kasey BKasey BGrimmettDmytriw, Adam AAdam ADmytriwEtherton, Mark RMark REthertonEzepue, ChizobaChizobaEzepueFarooqui, MudassirMudassirFarooquiFeske, Steven KSteven KFeskeFink, LaurenLaurenFinkGasimova, UlviyyaUlviyyaGasimovaGuzik, Amy KAmy KGuzikHakemi, MaryamMaryamHakemiHovingh, MajestaMajestaHovinghKhan, MuhibMuhibKhanJillela, DineshDineshJillelaKan, Peter TPeter TKanKhatri, RakeshRakeshKhatriKhawaja, Ayaz MAyaz MKhawajaKhoury, Naim NNaim NKhouryKiley, Nicole LNicole LKileyKim, Benny SBenny SKimKolikonda, Murali KMurali KKolikondaKuhn, Anna LuisaAnna LuisaKuhnLara, StephanieStephanieLaraLinares, GuillermoGuillermoLinaresLinfante, ItaloItaloLinfanteLukovits, Timothy GTimothy GLukovitsLycan, SarahSarahLycanMale, Shailesh SShailesh SMaleMaali, LaithLaithMaaliMancin, JohnJohnMancinMasoud, HeshamHeshamMasoudMohamed, Ghada AGhada AMohamedMonteiro, AndreAndreMonteiroNahab, FadiFadiNahabNalleballe, KrishnaKrishnaNalleballeGutierrez, Santiago OrtegaSantiago OrtegaGutierrezPuri, Ajit SAjit SPuriRadaideh, YazanYazanRadaidehRahangdale, Rahul HRahul HRahangdaleRai, AnsaarAnsaarRaiRamakrishnan, PankajavalliPankajavalliRamakrishnanReddy, Aravind BAravind BReddyRojas-Soto, Diana MDiana MRojas-SotoRomero, Jose RafaelJose RafaelRomeroRost, Natalia SNatalia SRostRothstein, AaronAaronRothsteinOmran, Setareh SalehiSetareh SalehiOmranSheth, Sunil ASunil AShethSiddiqui, Adnan HAdnan HSiddiquiStarosciak, Amy KAmy KStarosciakTarlov, Nicholas ENicholas ETarlovTaylor, Robert ARobert ATaylorWang, Michael JMichael JWangWolfe, JaredJaredWolfeWong, Ka-HoKa-HoWongLe, Huynh VuHuynh VuLeNguyen, Quy VietQuy VietNguyenPham, Thong NhuThong NhuPhamNguyen, Trung ThanhTrung ThanhNguyenPhan, Hoang ThiHoang ThiPhanTon, Mai DuyMai DuyTonFischer, Urs MartinUrs MartinFischerMichel, PatrikPatrikMichelStrambo, DavideDavideStramboMartins, Sheila OSheila OMartinsZaidat, Osama OOsama OZaidatNogueira, Raul GRaul GNogueira2024-10-112024-10-112023-01-24https://boris-portal.unibe.ch/handle/20.500.12422/88191BACKGROUND AND OBJECTIVES Declines in stroke admission, intravenous thrombolysis, and mechanical thrombectomy volumes were reported during the first wave of the COVID-19 pandemic. There is a paucity of data on the longer-term effect of the pandemic on stroke volumes over the course of a year and through the second wave of the pandemic. We sought to measure the impact of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), intravenous thrombolysis (IVT), and mechanical thrombectomy over a one-year period at the onset of the pandemic (March 1, 2020, to February 28, 2021) compared with the immediately preceding year (March 1, 2019, to February 29, 2020). METHODS We conducted a longitudinal retrospective study across 6 continents, 56 countries, and 275 stroke centers. We collected volume data for COVID-19 admissions and 4 stroke metrics: ischemic stroke admissions, ICH admissions, intravenous thrombolysis treatments, and mechanical thrombectomy procedures. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. RESULTS There were 148,895 stroke admissions in the one-year immediately before compared to 138,453 admissions during the one-year pandemic, representing a 7% decline (95% confidence interval [95% CI 7.1, 6.9]; p<0.0001). ICH volumes declined from 29,585 to 28,156 (4.8%, [5.1, 4.6]; p<0.0001) and IVT volume from 24,584 to 23,077 (6.1%, [6.4, 5.8]; p<0.0001). Larger declines were observed at high volume compared to low volume centers (all p<0.0001). There was no significant change in mechanical thrombectomy volumes (0.7%, [0.6,0.9]; p=0.49). Stroke was diagnosed in 1.3% [1.31,1.38] of 406,792 COVID-19 hospitalizations. SARS-CoV-2 infection was present in 2.9% ([2.82,2.97], 5,656/195,539) of all stroke hospitalizations. DISCUSSION There was a global decline and shift to lower volume centers of stroke admission volumes, ICH volumes, and IVT volumes during the 1st year of the COVID-19 pandemic compared to the prior year. Mechanical thrombectomy volumes were preserved. These results suggest preservation in the stroke care of higher severity of disease through the first pandemic year. TRIAL REGISTRATION INFORMATION This study is registered under NCT04934020.enCOVID-19 acute stroke intracranial hemorrhage intravenous thrombolysis ischemic stroke mechanical thrombectomy600 - Technology::610 - Medicine & healtharticle10.48350/1738893625771810.1212/WNL.0000000000201426