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Impact of COVID-19 pandemic on haemorrhagic stroke admissions: a systematic review and meta-analysis
Yijie You1, Yunlian Niu2, Fengbing Sun3
1Department of Neurosurgery, Shanghai Jiaotong University School of Medicine, Xinhua Hospital Chongming Branch, Shanghai, China cematianya@foxmail.com 13564338032@163.com.
Insights
The COVID-19 pandemic saw fewer stroke hospitalizations overall. However, there was a notable increase in hemorrhagic stroke cases, particularly intracerebral hemorrhage, during this period.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic has significantly impacted global healthcare systems and patient care.
- Understanding its effects on acute conditions like stroke is crucial for medical planning.
Purpose of the Study:
- To systematically review and meta-analyze the impact of the COVID-19 pandemic on stroke hospitalizations.
- To specifically evaluate changes in hemorrhagic stroke admissions during the pandemic.
Main Methods:
- A comprehensive literature search was conducted across multiple electronic databases (EMBASE, PubMed, Web of Science, etc.).
- Data from 17 studies involving 14,445 cases were extracted and analyzed.
- A fixed-effects model was employed to pool effect sizes, with risk of bias assessed using the Newcastle-Ottawa Scale.
Main Results:
- Overall stroke admissions decreased during the pandemic compared to the control period (6252 vs. 8193 cases).
- A significant increase in hemorrhagic stroke admissions was observed during the pandemic (1233/6252 vs. 1621/8193).
- Intracerebral hemorrhage admissions rose significantly, while the impact on subarachnoid hemorrhage remains unclear due to limited data.
Conclusions:
- Stroke hospitalizations were lower during the COVID-19 pandemic.
- The pandemic period was associated with a higher incidence rate of hemorrhagic stroke, especially intracerebral hemorrhage.
- Further research is needed to clarify the pandemic's effect on subarachnoid hemorrhage.
Background And Purpose:
COVID-19 pandemic, a global health crisis, is disrupting the present medical environment. This systematic review and meta-analysis aimed to evaluate the impact of the COVID-19 pandemic on stroke hospitalisations, especially haemorrhagic stroke.
Methods:
The EMBASE, PubMed, Web of Science, Elsevier, Medline, Cochrane Library and Google Scholar electronic databases were searched for all relevant studies. Two researchers independently screened the studies, extracted data and assessed the quality of the included studies. Odds ratio (OR), total events, OR and 95% CI were considered as the effect size. A fixed-effects model was used to pool the study-specific estimate. The present study was performed by using Review Manager (V.5.3.0) software. We assessed the risk of bias using the Newcastle-Ottawa Scale.
Results:
A total of 17 studies with 14 445 cases were included. Overall, the number of stroke admissions is lower in the pandemic period versus the control period (6252 vs 8193). The difference of haemorrhagic stroke is significant, with 1233 of 6252 cases in the pandemic group and 1621 of 8193 cases in the control group. Intracerebral haemorrhage is present in 461 of 1948 cases in the pandemic group and 618 of 2734 cases in the control group. As for subarachnoid haemorrhage, the difference between the two groups is significant, with 70 of 985 cases in the pandemic group and 202 of 1493 cases in the control group.
Conclusions:
The number of stroke admissions is lower in the pandemic period compared with the control period. There is a higher rate of haemorrhagic stroke in the pandemic period. Subgroup analysis identifies a significant increase in the occurrence of intracerebral haemorrhage in the pandemic period. Due to limited data and the impact of a single article, the impact of COVID-19 pandemic on subarachnoid haemorrhage is unclear.
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