@article{3101713,
    title = "Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic",
    author = "Nguyen, T.N. and Haussen, D.C. and Qureshi, M.M. and Yamagami, H. and Fujinaka, T. and Mansour, O.Y. and Abdalkader, M. and Frankel, M. and Qiu, Z. and Taylor, A. and Lylyk, P. and Eker, O.F. and Mechtouff, L. and Piotin, M. and Lima, F.O. and Mont'Alverne, F. and Izzath, W. and Sakai, N. and Mohammaden, M. and Al-Bayati, A.R. and Renieri, L. and Mangiafico, S. and Ozretic, D. and Chalumeau, V. and Ahmad, S. and Rashid, U. and Hussain, S.I. and John, S. and Griffin, E. and Thornton, J. and Fiorot, J.A. and Rivera, R. and Hammami, N. and Cervantes-Arslanian, A.M. and Dasenbrock, H.H. and Vu, H.L. and Nguyen, V.Q. and Hetts, S. and Bourcier, R. and Guile, R. and Walker, M. and Sharma, M. and Frei, D. and Jabbour, P. and Herial, N. and Al-Mufti, F. and Ozdemir, A.O. and Aykac, O. and Gandhi, D. and Chugh, C. and Matouk, C. and Lavoie, P. and Edgell, R. and Beer-Furlan, A. and Chen, M. and Killer-Oberpfalzer, M. and Pereira, V.M. and Nicholson, P. and Huded, V. and Ohara, N. and Watanabe, D. and Shin, D.H. and Magalhaes, P.S.C. and Kikano, R. and Ortega-Gutierrez, S. and Farooqui, M. and Abou-Hamden, A. and Amano, T. and Yamamoto, R. and Weeks, A. and Cora, E.A. and Sivan-Hoffmann, R. and Crosa, R. and Möhlenbruch, M. and Nagel, S. and Al-Jehani, H. and Sheth, S.A. and Rivera, V.S.L. and Siegler, J.E. and Sani, A.F. and Puri, A.S. and Kuhn, A.L. and Bernava, G. and Machi, P. and Abud, D.G. and Pontes-Neto, O.M. and Wakhloo, A.K. and Voetsch, B. and Raz, E. and Yaghi, S. and Mehta, B.P. and Kimura, N. and Murakami, M. and Lee, J.S. and Hong, J.M. and Fahed, R. and Walker, G. and Hagashi, E. and Cordina, S.M. and Roh, H.G. and Wong, K. and Arenillas, J.F. and Martinez-Galdamez, M. and Blasco, J. and Vasquez, A.R. and Fonseca, L. and Silva, M.L. and Wu, T.Y. and John, S. and Brehm, A. and Psychogios, M. and Mack, W.J. and Tenser, M. and Todaka, T. and Fujimura, M. and Novakovic, R. and Deguchi, J. and Sugiura, Y. and Tokimura, H. and Khatri, R. and Kelly, M. and Peeling, L. and Murayama, Y. and Winters, H.S. and Wong, J. and Teleb, M. and Payne, J. and Fukuda, H. and Miyake, K. and Shimbo, J. and Sugimura, Y. and Uno, M. and Takenobu, Y. and Matsumaru, Y. and Yamada, S. and Kono, R. and Kanamaru, T. and Morimoto, M. and Iida, J. and Saini, V. and Yavagal, D. and Bushnaq, S. and Huang, W. and Linfante, I. and Kirmani, J. and Liebeskind, D.S. and Szeder, V. and Shah, R. and Devlin, T.G. and Birnbaum, L. and Luo, J. and Churojana, A. and Masoud, H.E. and Lopez, C.Y. and Steinfort, B. and Ma, A. and Hassan, A.E. and Al Hashmi, A. and McDermott, M. and Mokin, M. and Chebl, A. and Kargiotis, O. and Tsivgoulis, G. and Morris, J.G. and Eskey, C.J. and Thon, J. and Rebello, L. and Altschul, D. and Cornett, O. and Singh, V. and Pandian, J. and Kulkarni, A. and Lavados, P.M. and Olavarria, V.V. and Todo, K. and Yamamoto, Y. and Silva, G.S. and Geyik, S. and Johann, J. and Multani, S. and Kaliaev, A. and Sonoda, K. and Hashimoto, H. and Alhazzani, A. and Chung, D.Y. and Mayer, S.A. and Fifi, J.T. and Hill, M.D. and Zhang, H. and Yuan, Z. and Shang, X. and Castonguay, A.C. and Gupta, R. and Jovin, T.G. and Raymond, J. and Zaidat, O.O. and Nogueira, R.G.",
    journal = "Stroke and Vascular Neurology",
    year = "2021",
    volume = "6",
    number = "4",
    pages = "542-552",
    publisher = "BMJ Publishing Group",
    issn = "2059-8696",
    doi = "10.1136/svn-2020-000695",
    keywords = "cross-sectional study;  diagnostic imaging;  human;  intracranial aneurysm;  pandemic;  prospective study;  retrospective study;  subarachnoid hemorrhage;  treatment outcome, COVID-19;  Cross-Sectional Studies;  Humans;  Intracranial Aneurysm;  Pandemics;  Prospective Studies;  Retrospective Studies;  SARS-CoV-2;  Subarachnoid Hemorrhage;  Treatment Outcome",
    abstract = "Background During 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. Methods We 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. Findings There 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. Interpretation There 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. ©"
}