The objectives of this study were to measure the global impact of the pandemic on
the volumes for intravenous thrombolysis (IVT), IVT transfers, and stroke hospitalizations
over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with
two control 4-month periods.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 and/or classifications in stroke databases.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%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 two later (May, June) versus the two earlier
(March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19
hospitalizations. SARS-CoV-2 infection was noted in 3.3% (1,722/52,026) of all stroke
admissions.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 COVID19 inpatient volumes experienced steeper declines. Recovery
of stroke hospitalization was noted in the later pandemic months.
