Impact of the COVID-19 pandemic on intracranial aneurysm treatment and associated Outcomes: A nationwide US-based study

Objective

Limited data on the treatment and outcomes of patients with intracranial aneurysms (ICAs) in the (coronavirus disease 2019) COVID-19 era is available. Our objective was hence to investigate the impact of the pandemic on the overall complication rate and postprocedural ischemic strokes specifically, in patients treated for ICAs.

Methods

The National Inpatient sample database was used. The main outcomes were the occurrence of postprocedural ischemic strokes, as well as death, non-routine discharge, total charges (US dollars), and length of stay (days). Propensity score matching was applied to compare the pre- and COVID-19 periods. Trends were assessed using piecewise joinpoint regression with the Mann-Kendall test.

Results

A total of 57,715 patients were included in the study. The mean age was 65 years, with most of the patients (69.9 %) being females. After matching, no differences in length of stay (p = 0.266), non-home discharge (p = 0.475), and in-hospital mortality rates (p = 0.305) between the two periods were found. However, the overall complication rate was significantly higher during the pandemic (31.1 % vs. 28.3 %; p < 0.001). Patients hospitalized after treatment of ICAs during the COVID-19 pandemic had significantly higher odds of ischemic strokes (OR 1.13; 95 % CI 1.05 to 1.22; p = 0.03), even when adjusting for other factors.

Conclusions

There is no denying that the COVID-19 pandemic has significantly impacted the healthcare system in several aspects. One aspect highlighted in this study, patient outcomes, was especially notable among patients’ receiving treatment for ICAs. Our results suggest a correlation between the COVID-19 pandemic and postprocedural complications, of which ischemic strokes were the most notable.