PT - JOURNAL ARTICLE AU - Thanh N Nguyen AU - Diogo C Haussen AU - Muhammad M Qureshi AU - Hiroshi Yamagami AU - Toshiyuki Fujinaka AU - Ossama Y Mansour AU - Mohamad Abdalkader AU - Michael Frankel AU - Zhongming Qiu AU - Allan Taylor AU - Pedro Lylyk AU - Omer F Eker AU - Laura Mechtouff AU - Michel Piotin AU - Fabricio Oliveira Lima AU - Francisco Mont'Alverne AU - Wazim Izzath AU - Nobuyuki Sakai AU - Mahmoud Mohammaden AU - Alhamza R Al-Bayati AU - Leonardo Renieri AU - Salvatore Mangiafico AU - David Ozretic AU - Vanessa Chalumeau AU - Saima Ahmad AU - Umair Rashid AU - Syed Irteza Hussain AU - Seby John AU - Emma Griffin AU - John Thornton AU - Jose Antonio Fiorot AU - Rodrigo Rivera AU - Nadia Hammami AU - Anna M Cervantes-Arslanian AU - Hormuzdiyar H Dasenbrock AU - Huynh Le Vu AU - Viet Quy Nguyen AU - Steven Hetts AU - Romain Bourcier AU - Romain Guile AU - Melanie Walker AU - Malveeka Sharma AU - Don Frei AU - Pascal Jabbour AU - Nabeel Herial AU - Fawaz Al-Mufti AU - Atilla Ozcan Ozdemir AU - Ozlem Aykac AU - Dheeraj Gandhi AU - Chandril Chugh AU - Charles Matouk AU - Pascale Lavoie AU - Randall Edgell AU - Andre Beer-Furlan AU - Michael Chen AU - Monika Killer-Oberpfalzer AU - Vitor Mendes Pereira AU - Patrick Nicholson AU - Vikram Huded AU - Nobuyuki Ohara AU - Daisuke Watanabe AU - Dong Hun Shin AU - Pedro SC Magalhaes AU - Raghid Kikano AU - Santiago Ortega-Gutierrez AU - Mudassir Farooqui AU - Amal Abou-Hamden AU - Tatsuo Amano AU - Ryoo Yamamoto AU - Adrienne Weeks AU - Elena A Cora AU - Rotem Sivan-Hoffmann AU - Roberto Crosa AU - Markus Möhlenbruch AU - Simon Nagel AU - Hosam Al-Jehani AU - Sunil A Sheth AU - Victor S Lopez Rivera AU - James E Siegler AU - Achmad Fidaus Sani AU - Ajit S Puri AU - Anna Luisa Kuhn AU - Gianmarco Bernava AU - Paolo Machi AU - Daniel G Abud AU - Octavio M Pontes-Neto AU - Ajay K Wakhloo AU - Barbara Voetsch AU - Eytan Raz AU - Shadi Yaghi AU - Brijesh P Mehta AU - Naoto Kimura AU - Mamoru Murakami AU - Jin Soo Lee AU - Ji Man Hong AU - Robert Fahed AU - Gregory Walker AU - Eiji Hagashi AU - Steve M Cordina AU - Hong Gee Roh AU - Ken Wong AU - Juan F Arenillas AU - Mario Martinez-Galdamez AU - Jordi Blasco AU - Alejandro Rodriguez Vasquez AU - Luisa Fonseca AU - M Luis Silva AU - Teddy Y Wu AU - Simon John AU - Alex Brehm AU - Marios Psychogios AU - William J Mack AU - Matthew Tenser AU - Tatemi Todaka AU - Miki Fujimura AU - Roberta Novakovic AU - Jun Deguchi AU - Yuri Sugiura AU - Hiroshi Tokimura AU - Rakesh Khatri AU - Michael Kelly AU - Lissa Peeling AU - Yuichi Murayama AU - Hugh Stephen Winters AU - Johnny Wong AU - Mohamed Teleb AU - Jeremy Payne AU - Hiroki Fukuda AU - Kosuke Miyake AU - Junsuke Shimbo AU - Yusuke Sugimura AU - Masaaki Uno AU - Yohei Takenobu AU - Yuji Matsumaru AU - Satoshi Yamada AU - Ryuhei Kono AU - Takuya Kanamaru AU - Masafumi Morimoto AU - Junichi Iida AU - Vasu Saini AU - Dileep Yavagal AU - Saif Bushnaq AU - Wenguo Huang AU - Italo Linfante AU - Jawad Kirmani AU - David S Liebeskind AU - Viktor Szeder AU - Ruchir Shah AU - Thomas G Devlin AU - Lee Birnbaum AU - Jun Luo AU - Anchalee Churojana AU - Hesham E Masoud AU - Carlos Ynigo Lopez AU - Brendan Steinfort AU - Alice Ma AU - Ameer E Hassan AU - Amal Al Hashmi AU - Mollie McDermott AU - Maxim Mokin AU - Alex Chebl AU - Odysseas Kargiotis AU - Georgios Tsivgoulis AU - Jane G Morris AU - Clifford J Eskey AU - Jesse Thon AU - Leticia Rebello AU - Dorothea Altschul AU - Oriana Cornett AU - Varsha Singh AU - Jeyaraj Pandian AU - Anirudh Kulkarni AU - Pablo M Lavados AU - Veronica V Olavarria AU - Kenichi Todo AU - Yuki Yamamoto AU - Gisele Sampaio Silva AU - Serdar Geyik AU - Jasmine Johann AU - Sumeet Multani AU - Artem Kaliaev AU - Kazutaka Sonoda AU - Hiroyuki Hashimoto AU - Adel Alhazzani AU - David Y Chung AU - Stephan A Mayer AU - Johanna T Fifi AU - Michael D Hill AU - Hao Zhang AU - Zhengzhou Yuan AU - Xianjin Shang AU - Alicia C Castonguay AU - Rishi Gupta AU - Tudor G Jovin AU - Jean Raymond AU - Osama O Zaidat AU - Raul G Nogueira AU - SVIN COVID-19 Registry, the Middle East North Africa Stroke and Interventional Neurotherapies Organization (MENA-SINO) ED - , TI - Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic AID - 10.1136/svn-2020-000695 DP - 2021 Dec 01 TA - Stroke and Vascular Neurology PG - 542--552 VI - 6 IP - 4 4099 - http://svn.bmj.com/content/6/4/542.short 4100 - http://svn.bmj.com/content/6/4/542.full SO - Stroke Vasc Neurol2021 Dec 01; 6 AB - 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.All data relevant to the study are included in the article or uploaded as supplementary information. Anonymised data are available upon reasonable request from the corresponding author.