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Aneurysmal Subarachnoid Hemorrhage during the Shutdown for COVID-19
Erdem Güresir1, Ingo Gräff2, Matthias Seidel2
1Department of Neurosurgery, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
Insights
Hospitalizations for aneurysmal subarachnoid hemorrhage (SAH) dropped significantly during the COVID-19 pandemic shutdown. Public health measures may have reduced modifiable risk factors like systemic inflammation, contributing to this decrease.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- Aneurysmal subarachnoid hemorrhage (SAH) is a critical neurological condition.
- The COVID-19 pandemic prompted unprecedented public health interventions globally.
- Understanding the impact of these measures on non-COVID-19 medical emergencies is crucial.
Purpose of the Study:
- To evaluate hospitalization rates for aneurysmal subarachnoid hemorrhage (SAH) within a neurovascular network (NVN).
- To assess the influence of the COVID-19 pandemic shutdown and associated public health measures on SAH incidence.
- To identify potential modifiable risk factors affected by the pandemic response.
Main Methods:
- A multicenter study comparing SAH admission rates during the COVID-19 shutdown (cw 12-16, 2020) with pre-shutdown, post-shutdown, and historical (2015-2019) periods.
- Analysis of all-cause and pre-hospital mortality data from health departments and emergency medical services.
- Investigation of potential triggers for systemic inflammation, including respiratory viruses and air pollution.
Main Results:
- Hospitalizations for SAH decreased by approximately 90% within the NVN during the COVID-19 shutdown period.
- A significant reduction in acute respiratory illness rates and air pollution was observed concurrently.
- The study period coincided with the implementation of public health measures like contact restrictions and enhanced hygiene.
Conclusions:
- The COVID-19 pandemic shutdown led to a dramatic decrease in SAH hospitalizations.
- Public health measures implemented during the shutdown may have positively impacted modifiable risk factors, such as systemic inflammation.
- Further research is warranted to elucidate the precise mechanisms linking public health interventions, inflammation, and SAH incidence.
Abstract:
The aim was to evaluate hospitalization rates for aneurysmal subarachnoid hemorrhage (SAH) within an interdisciplinary multicenter neurovascular network (NVN) during the shutdown for the COVID-19 pandemic along with its modifiable risk factors. In this multicenter study, admission rates for SAH were compared for the period of the shutdown for the COVID-19 pandemic in Germany (calendar weeks (cw) 12 to 16, 2020), the periods before (cw 6-11) and after the shutdown (cw 17-21 and 22-26, 2020), as well as with the corresponding cw in the years 2015-2019. Data on all-cause and pre-hospital mortality within the area of the NVN were retrieved from the Department of Health, and the responsible emergency medical services. Data on known triggers for systemic inflammation, e.g., respiratory viruses and air pollution, were analyzed. Hospitalizations for SAH decreased during the shutdown period to one-tenth within the multicenter NVN. There was a substantial decrease in acute respiratory illness rates, and of air pollution during the shutdown period. The implementation of public health measures, e.g., contact restrictions and increased personal hygiene during the shutdown, might positively influence modifiable risk factors, e.g., systemic inflammation, leading to a decrease in the incidence of SAH.
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