Impact of COVID-19 on the Volume of Acute Stroke Admissions: A Nationwide Survey in Japan

Takeshi Yoshimoto, Hiroshi Yamagami, Nobuyuki Sakai, Kazunori Toyoda, Yoichiro Hashimoto, Teruyuki Hirano, Toru Iwama, Rei Goto, Kazumi Kimura, Satoshi Kuroda, Yuji Matsumaru, Susumu Miyamoto, Kuniaki Ogasawara, Yasushi Okada, Yoshiaki Shiokawa, Yasushi Takagi, Teiji Tominaga, Masaaki Uno, Shinichi Yoshimura, Nobuyuki OharaHirotoshi Imamura, Chiaki Sakai

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


This study aimed to measure the impact of the COVID-19 pandemic on the volumes of annual stroke admissions compared with those before the pandemic in Japan. We conducted an observational, retrospective nationwide survey across 542 primary stroke centers in Japan. The annual admission volumes for acute stroke within 7 days from onset between 2019 as the pre-pandemic period and 2020 as the pandemic period were compared as a whole and separately by months during which the epidemic was serious and prefectures of high numbers of infected persons. The number of stroke patients declined from 182,660 in 2019 to 178,083 in 2020, with a reduction rate of 2.51% (95% confidence interval [CI], 2.58%-2.44%). The reduction rates were 1.92% (95% CI, 1.85%-2.00%; 127,979-125,522) for ischemic stroke, 3.88% (95% CI, 3.70%-4.07%, 41,906-40,278) for intracerebral hemorrhage, and 4.58% (95% CI, 4.23%-4.95%; 13,020-12,424) for subarachnoid hemorrhage. The admission volume declined by 5.60% (95% CI, 5.46%-5.74%) during the 7 months of 2020 when the epidemic was serious, whereas it increased in the remaining 5 months (2.01%; 95% CI, 1.91%-2.11%). The annual decline in the admission volume was predominant in the five prefectures with the largest numbers of infected people per mil-lion population (4.72%; 95% CI, 4.53%-4.92%). In conclusion, the acute stroke admission volume declined by 2.51% in 2020 relative to 2019 in Japan, especially during the months of high infection, and in highly infected prefectures. Overwhelmed healthcare systems and infection control practices may have been associated with the decline in the stroke admission volume during the COVID-19 pandemic.

Original languageEnglish
Pages (from-to)369-376
Number of pages8
JournalNeurologia medico-chirurgica
Issue number8
Publication statusPublished - 2022
Externally publishedYes


  • Japan
  • admission
  • coronavirus disease-2019
  • nationwide survey
  • stroke

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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