Department of Neurosurgery, University Hospital of Patras, 26504, Rio, Patras, Greece.
Department of Neurology, University Hospital of Patras, 26504, Rio, Patras, Greece.
Neurol Sci. 2021 Jun;42(6):2167-2172. doi: 10.1007/s10072-021-05190-6. Epub 2021 Mar 21.
Acute subarachnoid hemorrhage (SAH) due to aneurysmal rupture is a devastating vascular disease accounting for 5% of strokes. COVID-19 pandemic resulted in a decrease in elective and emergency admissions in the majority of neurosurgical centers. The main hypothesis was that fear of COVID-19 may have prevented patients with critical medical or surgical emergencies from actively presenting in emergency departments and outpatient clinics.
We conducted a single-center, retrospective, observational study searching our institutional data regarding the incidence of spontaneous subarachnoid hemorrhage (SAH) and compare the admissions in two different periods: the pre COVID-19 with the COVID-19 period.
The study cohort was comprised of a total of 99 patients. The mean (SD) weekly case rate of patients with SAH was 1.1 (1.1) during the pre-COVID-19 period, compared to 1.7 (1.4) during the COVID-19 period. Analysis revealed that the volume of admitted patients with SAH was 1.5-fold higher during the COVID period compared to the pre-COVID period and this was statistically significant (ExpB = 1.5, CI 95% 1-2.3, p = 0.044). Difference in mortality did not reach any statistical significance between the two periods (p = 0.097), as well as patients' length of stay (p = 0.193).
The presented data cover a more extended time period than so far published reports; it is reasonable that our recent experience may well be demonstrating a general realistic trend of overall increase in aneurysmal rupture rates during lockdown. Hospitalization of patients with SAH cannot afford any reductions in facilities, equipment, or personnel if optimum outcomes are desirable.
由于动脉瘤破裂导致的急性蛛网膜下腔出血（SAH）是一种破坏性的血管疾病，占中风的 5%。COVID-19 大流行导致大多数神经外科中心的择期和急诊入院人数减少。主要假设是，对 COVID-19 的恐惧可能阻止了有重大医疗或外科紧急情况的患者积极到急诊部门和门诊就诊。
我们进行了一项单中心、回顾性、观察性研究，检索了我们机构关于自发性蛛网膜下腔出血（SAH）发病率的数据，并比较了两个不同时期的入院人数：COVID-19 前时期和 COVID-19 时期。
研究队列共包括 99 名患者。COVID-19 前时期，每周 SAH 患者的平均（SD）病例发生率为 1.1（1.1），而 COVID-19 时期为 1.7（1.4）。分析显示，COVID 期间入院的 SAH 患者人数是 COVID-19 前时期的 1.5 倍，这具有统计学意义（ExpB=1.5，CI95%1-2.3，p=0.044）。两个时期之间的死亡率差异没有达到统计学意义（p=0.097），患者的住院时间也没有达到统计学意义（p=0.193）。
与迄今为止发表的报告相比，本研究数据涵盖了更长的时间段；我们最近的经验很可能表明，在封锁期间，动脉瘤破裂率总体上升是一种普遍的现实趋势，这是合理的。如果要达到最佳结果，SAH 患者的住院治疗不能减少设施、设备或人员。
