@article {Nguyensvn-2020-000695, author = {Thanh N Nguyen and Diogo C Haussen and Muhammad M Qureshi and Hiroshi Yamagami and Toshiyuki Fujinaka and Ossama Y Mansour and Mohamad Abdalkader and Michael Frankel and Zhongming Qiu and Allan Taylor and Pedro Lylyk and Omer F Eker and Laura Mechtouff and Michel Piotin and Fabricio Oliveira Lima and Francisco Mont{\textquoteright}Alverne and Wazim Izzath and Nobuyuki Sakai and Mahmoud Mohammaden and Alhamza R Al-Bayati and Leonardo Renieri and Salvatore Mangiafico and David Ozretic and Vanessa Chalumeau and Saima Ahmad and Umair Rashid and Syed Irteza Hussain and Seby John and Emma Griffin and John Thornton and Jose Antonio Fiorot and Rodrigo Rivera and Nadia Hammami and Anna M Cervantes-Arslanian and Hormuzdiyar H Dasenbrock and Huynh Le Vu and Viet Quy Nguyen and Steven Hetts and Romain Bourcier and Romain Guile and Melanie Walker and Malveeka Sharma and Don Frei and Pascal Jabbour and Nabeel Herial and Fawaz Al-Mufti and Atilla Ozcan Ozdemir and Ozlem Aykac and Dheeraj Gandhi and Chandril Chugh and Charles Matouk and Pascale Lavoie and Randall Edgell and Andre Beer-Furlan and Michael Chen and Monika Killer-Oberpfalzer and Vitor Mendes Pereira and Patrick Nicholson and Vikram Huded and Nobuyuki Ohara and Daisuke Watanabe and Dong Hun Shin and Pedro SC Magalhaes and Raghid Kikano and Santiago Ortega-Gutierrez and Mudassir Farooqui and Amal Abou-Hamden and Tatsuo Amano and Ryoo Yamamoto and Adrienne Weeks and Elena A Cora and Rotem Sivan-Hoffmann and Roberto Crosa and Markus M{\"o}hlenbruch and Simon Nagel and Hosam Al-Jehani and Sunil A Sheth and Victor S Lopez Rivera and James E Siegler and Achmad Fidaus Sani and Ajit S Puri and Anna Luisa Kuhn and Gianmarco Bernava and Paolo Machi and Daniel G Abud and Octavio M Pontes-Neto and Ajay K Wakhloo and Barbara Voetsch and Eytan Raz and Shadi Yaghi and Brijesh P Mehta and Naoto Kimura and Mamoru Murakami and Jin Soo Lee and Ji Man Hong and Robert Fahed and Gregory Walker and Eiji Hagashi and Steve M Cordina and Hong Gee Roh and Ken Wong and Juan F Arenillas and Mario Martinez-Galdamez and Jordi Blasco and Alejandro Rodriguez Vasquez and Luisa Fonseca and M Luis Silva and Teddy Y Wu and Simon John and Alex Brehm and Marios Psychogios and William J Mack and Matthew Tenser and Tatemi Todaka and Miki Fujimura and Roberta Novakovic and Jun Deguchi and Yuri Sugiura and Hiroshi Tokimura and Rakesh Khatri and Michael Kelly and Lissa Peeling and Yuichi Murayama and Hugh Stephen Winters and Johnny Wong and Mohamed Teleb and Jeremy Payne and Hiroki Fukuda and Kosuke Miyake and Junsuke Shimbo and Yusuke Sugimura and Masaaki Uno and Yohei Takenobu and Yuji Matsumaru and Satoshi Yamada and Ryuhei Kono and Takuya Kanamaru and Masafumi Morimoto and Junichi Iida and Vasu Saini and Dileep Yavagal and Saif Bushnaq and Wenguo Huang and Italo Linfante and Jawad Kirmani and David S Liebeskind and Viktor Szeder and Ruchir Shah and Thomas G Devlin and Lee Birnbaum and Jun Luo and Anchalee Churojana and Hesham E Masoud and Carlos Ynigo Lopez and Brendan Steinfort and Alice Ma and Ameer E Hassan and Amal Al Hashmi and Mollie McDermott and Maxim Mokin and Alex Chebl and Odysseas Kargiotis and Georgios Tsivgoulis and Jane G Morris and Clifford J Eskey and Jesse Thon and Leticia Rebello and Dorothea Altschul and Oriana Cornett and Varsha Singh and Jeyaraj Pandian and Anirudh Kulkarni and Pablo M Lavados and Veronica V Olavarria and Kenichi Todo and Yuki Yamamoto and Gisele Sampaio Silva and Serdar Geyik and Jasmine Johann and Sumeet Multani and Artem Kaliaev and Kazutaka Sonoda and Hiroyuki Hashimoto and Adel Alhazzani and David Y Chung and Stephan A Mayer and Johanna T Fifi and Michael D Hill and Hao Zhang and Zhengzhou Yuan and Xianjin Shang and Alicia C Castonguay and Rishi Gupta and Tudor G Jovin and Jean Raymond and Osama O Zaidat and Raul G Nogueira and SVIN COVID-19 Registry, the Middle East North Africa Stroke and Interventional Neurotherapies Organization (MENA-SINO)}, editor = {,}, title = {Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic}, elocation-id = {svn-2020-000695}, year = {2021}, doi = {10.1136/svn-2020-000695}, publisher = {BMJ Specialist Journals}, abstract = {Background During the COVID-19 pandemic, decreased volumes of stroke admissions and mechanical thrombectomy were reported. The study{\textquoteright}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{\textendash}31 May 2020. The prior 1-year control period (1 March{\textendash}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{\textendash}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.}, issn = {2059-8688}, URL = {https://svn.bmj.com/content/early/2021/03/25/svn-2020-000695}, eprint = {https://svn.bmj.com/content/early/2021/03/25/svn-2020-000695.full.pdf}, journal = {Stroke and Vascular Neurology} }