Denise Battaglini, Thu-Lan Kelly, Matthew Griffee, Jonathon Fanning, Lavienraj Premraj, Glenn Whitman, Diego Bastos Porto, Rakesh Arora, David Thomson, Paolo Pelosi, Nicole M. White, Gianluigi Li Bassi, Jacky Suen, John F. Fraser, Chiara Robba, Sung-Min Cho, Tala Al-Dabbous, Huda Alfoudri, Mohammed Shamsah, Khadeejeh Alfroukh, Zinah Aqeel Abdulzahra Bairmani, Khalid Jehad Khalid, Salsabeel M.A. Abukhalaf, Mohammed Maher Hadhoud, Mohamed Fouad Abdrabo, Mohamed Fathi, Hasan Alhouri, Dr Hamza Shahla, Qamrah Alhadad, Matly Hanan, Subbarao Elapavaluru, Ashley Berg, Christina Horn, Ahmed Reda Mohamed Elsayed Abdelhalim, Amro Essam Amer, Cinderella Omar Rageh Elnaggar, Ahmed Ayman Hassan, Ali Abdelaziz, Mohamed Abdelhalim, Yehia Samir Shaaban Aly Orabi, Zinah A. Alaraji, Mo'nes R. Muhaisen, Lana Almasri, Dana Mustafa, Shaher Hamdan, Yousef Al-Saba'a, Zaina Dalloul, Mohammed Alkahlout, Hamza Jaber, Osama Aldabbourosama, Alaa Abdalfattah Abdalhadi, Aliae AR Mohamed Hussein, Zarief Kamel Emad, Sarah Khaled, Nouralsabah Mohamed, Ebtisam Hassanin, Abdelhafeez Hamdi, May Gamal, Ahmed Emad, Abdelrahman Ragab, Mohammed G Azizeldin, Almthani Hamza, Alsarrah Ali Mohammed Omer, Asgad Osman Abdalla Fadl alla, Asia Atif Abdelrahman Abdallahrs, Aml Ahmed Eltayeb, Maali khalid mohamed abdalla Alhasan, Esraa Hassan Abdelgaum, Aya Mustafa Ahmed, Lamees Adil Abdulbaqi, Omer Abdullah Mohammedelhassan, Musaab Mohammed Mohammed Ahmed, Maha TagElser Mohammed Ali, Yunis Mayasi, Stephan Schroll, Dan Meyer, Jorge Velazco, Ludmyla Ploskanych, Wanda Fikes, Rohini Bagewadi, Marvin Dao, Haley White, Alondra Berrios Laviena, Ashley Ehlers, Maysoon Shalabi-McGuire, Trent Witt, Lorenzo Grazioli, Luca Lorini, E. Wilson Grandin, Jose Nunez, Tiago Reyes, Diarmuid O'Briain, Stephanie Hunter, Mahesh Ramanan, Julia Affleck, Hemanth Hurkadli Veerendra, Sumeet Rai, Josie Russell-Brown, Mary Nourse, Mark Joseph, Brook Mitchell, Martha Tenzer, Ryuzo Abe, Hwa Jin Cho, In Seok Jeong, Nadeem Rahman, Vivek Kakar, Ahmed Tamimi, Diala Zabalawi, Mohamed Elhennawi, Praveen Ghisulal, Sadaf Malik, Nicolas Brozzi, Omar Mehkri, Sudhir Krishnan, Abhijit Duggal, Stuart Houltham, Jerónimo Graf, Roderigo Diaz, Roderigo Orrego, Camila Delgado, Joyce González, Maria Soledad Sanchez, Michael Piagnerelli, Josefa Valenzuela Sarrazin, Prof. Gustavo Zabert, Lucio Espinosa, Paulo Delgado, Victoria Delgado, Diego Fernando Bautista Rincón, Angela Maria Marulanda Yanten, Melissa Bustamante Duque, Daniel Brodie, Khaled Abouelmagd, Alyaa Elhazmi, Abdullah Al-Hudaib, Jeff Javidfar, Maria Callahan, Andy Dong, Charles Crepy D'Orleans, M. Azhari Taufik, Elizabeth Yasmin Wardoyo, Margaretha Gunawan, Nurindah S Trisnaningrum, Vera Irawany, Muhammad Rayhan, Mauro Panigada, Antonio Pesenti, Alberto Zanella, Giacomo Grasselli, Sebastiano Colombo, Chiara Martinet, Gaetano Florio, Massimo Antonelli, Simone Carelli, Domenico L. Grieco, Motohiro Asaki, Kota Hoshino, Leonardo Salazar, Mary Alejandra Mendoza Monsalve, John Laffey, Bairbre McNicholas, David Cosgrave, Minha Atif, Fadi Qutishat, Caoimhe Laffey, Michaeal Van Der Walt, Joseph McCaffrey, Allison Bone, Jemma Trickey, Michelle Horton, Stephanie Pearce, Tania Salerno, Akram Mohamed, Salem Alhaddad, Baliad Bakeer, Shames Haitam, Laila Shalabi, Mohammed Abodina Ahmed, Yusuff Hakeem, James Winearls, Mandy Tallott, Ivan Joubert, Christel Arnold-Day, Jenna Piercy, Richard van Zyl Smit, Malcom Miller, Lisa Seymour, Francois van Heyningen, Gilbert Teyangesikayi, David Fredericks, Ali Ait Hssain, Jeffrey Aliudin, Al-Reem Alqahtani, Khoulod Mohamed, Ahmed Mohamed, Darwin Tan, Joy Villanueva, Ahmed Zaqout, Ahmed Labib, Ethan Kurtzman, Arben Ademi, Ana Dobrita, Khadija El Aoudi, Juliet Segura, Gezy Giwangkancana, Shinichiro Ohshimo, Javier Osatnik, Anne Joosten, Antoni Torres, Minlan Yang, Ana Motos, Carlos Luna, Francisco Arancibia, Virginie Williams, Alexandre Noel, Nestor Luque, Marina Fantini, Ruth Noemi Jorge García, Enrique Chicote Alvarez, Anna Greti, Adrian Ceccato, Angel Sanchez, Ana Loza Vazquez, Ferran Roche-Campo, Diego Franch-Llasat, Divina Tuazon, Marcelo Amato, Luciana Cassimiro, Flavio Pola, Francis Ribeiro, Guilherme Fonseca, Heidi Dalton, Mehul Desai, Erik Osborn, Hala Deeb, Antonio Arcadipane, Gennaro Martucci, Giovanna Panarello, Stefano Vitiello, Claudia Bianco, Giovanna Occhipinti, Matteo Rossetti, Raffaele Cuffaro, Nidhal Siddig, Marwan El Sayed, Walaa Mokhtar, Eslam El-Shenawy, Hiroaki Shimizu, Naoki Moriyama, Jae-Burm Kim, Nobuya Kitamura, Johannes Gebauer, Toshiki Yokoyama, Abdulrahman Al-Fares, Sarah Buabbas, Esam Alamad, Fatma Alawadhi, Kalthoum Alawadi, Mohamed Ahmed Khalefa, Nourah Ahmad Abdulaziz Al Ajeel, Mohammad Fathy Aly, Abdullah Al-Saleh, Abdullah Naanouh, Alaa Mohammed Elshourbgy, Mohamed Yousef Gad, Rania Mohamed ElRazaz, Ibrahim Khadadah, Ahmed Mohammed Almumin, Hala Altarakma, Hasan Albannay, Mohammed Kh Alsaleh, Mahmoud Saad Abdallah Radwan, Islam Ahmed Saadallah, Hiro Tanaka, Satoru Hashimoto, Masaki Yamazaki, Tak-Hyuck Oh, Mark Epler, Cathleen Forney, Louise Kruse, Jared Feister, Joelle Williamson, Katherine Grobengieser, Eric Gnall, Sasha Golden, Mara Caroline, Timothy Shapiro, Colleen Karaj, Lisa Thome, Lynn Sher, Mark Vanderland, Mary Welch, Sherry McDermott, Matthew Brain, Sarah Mineall, Maria Unwin, Lixian Chen, Tarnya Trezise, Laurie McKeon, Dai Kimura, Luca Brazzi, Gabriele Sales, Giorgia Montrucchio, Tawnya Ogston, Dave Nagpal, Karlee Fischer, Roberto Lorusso, Bas van Bussell, Maria Elena De Piero, Silvia Mariani, Dr Rajavardhan Rangappa, Dr Rajesh Mohan Shetty, Sujin Rai P, Argin Ganesan, Samar Tharwat, Mariano Esperatti, Nora Angélica Fuentes, Maria Eugenia Gonzalez, Edmund G. Carton, Ayan Sen, Amanda Palacios, Deborah Rainey, Gordan Samoukoviv, Josie Campisi, Lucia Durham, Emily Neumann, Cassandra Seefeldt, Octavio Falcucci, Amanda Emmrich, Jennifer Guy, Carling Johns, Kelly Potzner, Catherine Zimmermann, Angelia Espinal, Nina Buchtele, Michael Schwameis, Andrea Korhnfehl, Roman Brock, Thomas Staudinger, Stephanie-Susanne Stecher, Michaela Barnikel, Sófia Antón, Alexandra Pawlikowski, Akram Zaaqoq, Lan Anh Galloway, Caitlin Merley, Mohamed Muftah, Alistair Nichol, Marc Csete, Luisa Quesada, Isabela Saba, Daisuke Kasugai, Hiroaki Hiraiwa, Taku Tanaka, Eva Marwali, Yoel Purnama, Santi Rahayu Dewayanti, Ardiyan, Dafsah Arifa Juzar, Debby Siagian, Yih-Sharng Chen, Amer Aldhalia, Mark Ogino, Prashant Nasa, Christina Matthew, Nimisha Abdul Majeed, Wael Hafez, Indrek Ratsep, Andra-Maris Post, Piret Sillaots, Anneli Krund, Merili-Helen Lehiste, Tanel Lepik, Frank Manetta, Effe Mihelis, Iam Claire Sarmiento, Mangala Narasimhan, Michael Varrone, Mamoru Komats, Julia Garcia-Diaz, Catherine Harmon, S. Veena Satyapriya, Amar Bhatt, Nahush A. Mokadam, Alberto Uribe, Alicia Gonzalez, Haixia Shi, Johnny McKeown, Joshua Pasek, Juan Fiorda, Marco Echeverria, Rita Moreno, Bishoy Zakhary, Marco Cavana, Alberto Cucino, Giuseppe Foti, Marco Giani, Benedetta Fumagalli, Davide Chiumello, Valentina Castagna, Andrea Dell'Amore, Paolo Navalesi, Hoi-Ping Shum, Alain Vuysteke, Asad Usman, Andrew Acker, Benjamin Smood, Blake Mergler, Federico Sertic, Madhu Subramanian, Alexandra Sperry, Nicolas Rizer, Erlina Burhan, Menaldi Rasmin, Ernita Akmal, Faya Sitompul, Navy Lolong, Bhat Naivedh, Simon Erickson, Peter Barrett, David Dean, Julia Daugherty, Antonio Loforte, Irfan Khan, Mohammed Abraar Quraishi, Olivia DeSantis, Ahmad Nasrallah, Dominic So, Darshana Kandamby, Jose M. Mandei, Hans Natanael, Eka YudhaLantang, Anastasia Lantang, Surya Oto Wijaya, Anna Jung, George Ng, Wing Yiu Ng, Pauline Yeung Ng, Shu Fang, Alexis Tabah, Megan Ratcliffe, Maree Duroux, Ahmed Alajeeli, Ali Tarhabat, Shingo Adachi, Shota Nakao, Pablo Blanco, Ana Prieto, Jesús Sánchez, Meghan Nicholson, Warwick Butt, Alyssa Serratore, Carmel Delzoppo, Pierre Janin, Elizabeth Yarad, Richard Totaro, Jennifer Coles, Bambang Pujo, Robert Balk, Andy Vissing, Esha Kapania, James Hays, Samuel Fox, Garrett Yantosh, Pavel Mishin, Safia Adem, Saptadi Yuliarto, Kohar Hari Santoso, Susanthy Djajalaksana, Arie Zainul Fatoni, Masahiro Fukuda, Keibun Liu, Juan Fernando Masa Jiménez, Diego Bastos, Sérgio Gaião, Desy Rusmawatiningtyas, Young-Jae Cho, Su Hwan Lee, Tatsuya Kawasaki, Laveena Munshi, Pranya Sakiyalak, Prompak Nitayavardhana, Mohamed Bashir Elagili, Talat Ahmed Abu Salem, Tamara Seitz, David Kent, Daniel Marino, Swapnil Parwar, Andrew Cheng, Jennene Miller, Shigeki Fujitani, Naoki Shimizu, Jai Madhok, Clark Owyang, Hergen Buscher, Claire Reynolds, Abusalama Abdurraouf, Ali Abdulnasir Kredan, Abdurrahman Haddud, Saad Moharam, Olavi Maasikas, Aleksan Beljantsev, Vladislav Mihnovits, Takako Akimoto, Mariko Aizawa, Kanako Horibe, Ryota Onodera, Carol Hodgson, Aidan Burrell, Meredith Young, Timothy George, Kiran Shekar, Niki McGuinness, Lacey Irvine, Brigid Flynn, Abdulrahman Almjersah, Ashraf Bakri, Tomoyuki Endo, Kazuhiro Sugiyama, Keiki Shimizu, Eddy Fan, Kathleen Exconde, Shingo Ichiba, Muhannud Binnawara, Hussein Embarek, Leslie Lussier, Gösta Lotz, Maximilian Malfertheiner, Lars Maier, Esther Dreier, Neurinda Permata Kusumastuti, Colin McCloskey, Al-Awwab Dabaliz, Tarek B Elshazly, Josiah Smith, Konstanty S. Szuldrzynski, Piotr Bielański, Keith Wille, Srinivas Murthy, Ken Kuljit S. Parhar, Kirsten M. Fiest, Cassidy Codan, Anmol Shahid, Mohamed Fayed, Timothy Evans, Rebekah Garcia, Ashley Gutierrez, Tae Song, Rebecca Rose, Suzanne Bennett, Denise Richardson, Giles Peek, Lovkesh Arora, Kristina Rappapport, Kristina Rudolph, Zita Sibenaller, Lori Stout, Alicia Walter, Daniel Herr, Nazli Vedadi, Robert Bartlett, Shaun Thompson, Julie Hoffman, Xiaonan Ying, Bailey Williams, Emely Sanchez, Chika Akwani, Ryan Kennedy, Muhammed Elhadi, Mary Mone, Anna Ciullo, Yuri Kida, Ricard Ferrer Roca, JordI Riera, Sofia Contreras, Cynthia Alegre, Christy Kay, Irene Fischer, Elizabeth Renner, Hayato Taniguci, James Lee, Daniel Plotkin, Barbara Wanjiru Citarella, Laura Merson, Emma Hartley, Bastian Lubis, Takanari Ikeyama, Alshaymaa Mortada, Ameen Alhamad, Ahmed Mechi, Islam Mohsen Ali Mohamed Hassan Nadar, Mohammed Saleh Alyasiri, Muhammed Zainab Alghali Elsaid, Balu Bhaskar, Jae-Seung Jung, Shay McGuinness, Glenn Eastwood, Sandra Rossi Marta, Fabio Guarracino, Stacy Gerle, Emily Coxon, Bruno Claro, Wafa Aldressi, Mahmoud Eleisawy, Hasnaa Osama, Daniel Loverde, Namrata Patil, Vieri Parrini, Angela McBride, Kathryn Negaard, Angela Ratsch, Ahmad Abdelaziz, Juan David Uribe, Adriano Peris, Mark Sanders, Dominic Emerson, Muhammad Kamal, Hamza Faida, Pedro Povoa, Roland Francis, Ali Cherif, Sunimol Joseph, Matteo Di Nardo, Micheal Heard, Kimberly Kyle, Ray A Blackwell, Amel OUYAHIA, Patrick Biston, Hye Won Jeong, Reanna Smith, Yogi Prawira, Arturo Huerta Garcia, Nahikari Salterain, Bart Meyns, Muhammed Elnasser, Marsha Moreno, Rajat Walia, Amit Mehta, Annette Schweda, Melissa Williams, Emad Amkhatirah, Kyung Hoon Kim, Alexandra Assad, Estefania Giraldo, Wojtek Karolak, Martin Balik, Elizabeth Pocock, Evan Gajkowski, Mohamed Bedair, Kanamoto Masafumi, Nicholas Barrett, Yoshihiro Takeyama, Sunghoon Park, Faizan Amin, Fina Meilyana Andriyani, Serhii Sudakevych, Janos Schnur, Magdalena Vera, Rodrigo Cornejo, Patrícia Schwarz, Ana Carolina Mardini, Thais de Paula, Ary Serpa Neto, Andrea Villoldo, Alexandre Siciliano Colafranceschi, Alejandro Ubeda Iglesias, Juan Granjean, Lívia Maria Garcia Melro, Giovana Fioravante Romualdo, Diego Gaia, Helmgton Souza, Filomena Galas, Rafael Máñez Mendiluce, Alejandra Sosa, Ignacio Martinez, Hiroshi Kurosawa, Mohammad Badr Almoshantaf, Juan Salgado, Beate Hugi-Mayr, Eric Charbonneau, Vitor Salvatore Barzilai, Veronica Monteiro, Rodrigo Ribeiro de Souza, Michael Harper, Hiroyuki Suzuki, Celina Adams, Jorge Brieva, Almu'atasim Khamees, Fadi Graige, Moh Supriatna, George Nyale, Faisal Saleem Eltatar, Jihan Fatani, Husam Baeissa, Ayman AL Masri, Ahmed Rabie, Mok Yee Hui, Masahiro Yamane, Hanna Jung, Ayorinde Mojisola Margaret, Newell Nacpil, Katja Ruck, Rhonda Bakken, Claire Jara, Tim Felton, Lorenzo Berra, Bobby Shah, Arpan Chakraborty, Monika Cardona, Gerry Capatos, Bindu Akkanti, Abiodun Orija, Harsh Jain, Asami Ito, Brahim Housni, Sennen Low, Koji Iihara, Joselito Chavez, Kollengode Ramanathan, Gustavo Zabert, Krubin Naidoo, Ian Seppelt, Marlice VanDyk, Sarah MacDonald, Randy McGregor, Teka Siebenaler, Hannah Flynn, Kristi Lofton, Toshiyuki Aokage, Bakar Kvirkvelia, Kazuaki Shigemitsu, Andrea Moscatelli, Giuseppe Fiorentino, Matthias Baumgaertel, Serge Eddy Mba, Jana Assy, Amelya Hutahaean, Holly Roush, Kay A Sichting, Francesco Alessandri, Debra Burns, Taha Husayn Alkhubouli, Gavin Salt, Carl P. Garabedian, Jonathan Millar, Malcolm Sim, Adrian Mattke, Danny McAuley, Jawad Tadili, Tim Frenzel, Amro Abuleil, Yaron Bar-Lavie, Aaron Blandino Ortiz, Jackie Stone, Antony Attokaran, Michael Farquharson, Brij Patel, Derek Gunning, Kenneth Baillie, Pia Watson, Kenji Tamai, Ayoub Saaid, Pasquale Anania, Gede Ketut Sajinadiyasa, Dyah Kanyawati, Marcello Salgado, Assad Sassine, Bhirowo Yudo, Scott McCaul, Bongjin Lee, Sang Min Lee, Arnon Afek, Shimaa E Fattouh, Yoshiaki Iwashita, Hammad Fadlalmola, Bambang Pujo Semedi, Noureldin Mohamed Mansour, Jack Metiva, Nicole Van Belle, Ignacio Martin-Loeches, Dr Mohammed Al-Sadawi, Cenk Kirakli, Al-Touny Shimaa, Lenny Ivatt, Chia Yew Woon, Hyun Mi Kang, Timothy Smith, Erskine James, Nawar Al-Rawas, Yudai Iwasaki, Hamza Ashour, Kenny Chan King-Chung, Vadim Gudzenko, Fabio Taccone, Fajar Perdhana, Yoan Lamarche, Joao Miguel Ribeiro, Nikola Bradic, Klaartje Van den Bossche, Oude Lansink, Gurmeet Singh, Gerdy Debeuckelaere, Henry T. Stelfox, Cassia Yi, Jennifer Elia, Thomas Tribble, Shyam Shankar, Raj Padmanabhan, Bill Hallinan, Luca Paoletti, Yolanda Leyva, Tatuma Fykuda, Jenelle Badulak, Jillian Koch, Lisa Janowaik, Amy Hackman, Deb Hernandez, Jennifer Osofsky, Katia Donadello, Aizah Lawang, Josh Fine, Benjamin Davidson, Andres Oswaldo Razo Vazquez, Ibrahim Abdehaleem
Purpose: We aimed to compare the incidence of stroke in low-and middle-income countries (LMICs) versus high-income countries (HICs) in critically ill patients with COVID-19 and its impact on in-hospital mortality. Methods: International observational study conducted in 43 countries. Stroke and mortality incidence rates and rate ratios (IRR) were calculated per admitted days using Poisson regression. Inverse probability weighting (IPW) was used to address the HICs vs. LMICs imbalance for confounders. Results: 23,738 patients [20,511(86.4 %) HICs vs. 3,227(13.6 %) LMICs] were included. The incidence stroke/1000 admitted-days was 35.7 (95 %CI = 28.4–44.9) LMICs and 17.6 (95 %CI = 15.8–19.7) HICs; ischemic 9.47 (95 %CI = 6.57–13.7) LMICs, 1.97 (95 %CI = 1.53, 2.55) HICs; hemorrhagic, 7.18 (95 %CI = 4.73–10.9) LMICs, and 2.52 (95 %CI = 2.00–3.16) HICs; unspecified stroke type 11.6 (95 %CI = 7.75–17.3) LMICs, 8.99 (95 %CI = 7.70–10.5) HICs. In regression with IPW, LMICs vs. HICs had IRR = 1.78 (95 %CI = 1.31–2.42, p < 0.001). Patients from LMICs were more likely to die than those from HICs [43.6% vs 29.2 %; Relative Risk (RR) = 2.59 (95 %CI = 2.29–2.93), p < 0.001)]. Patients with stroke were more likely to die than those without stroke [RR = 1.43 (95 %CI = 1.19–1.72), p < 0.001)]. Conclusions: Stroke incidence was low in HICs and LMICs although the stroke risk was higher in LMICs. Both LMIC status and stroke increased the risk of death. Improving early diagnosis of stroke and redistribution of healthcare resources should be a priority. Trial registration: ACTRN12620000421932 registered on 30/03/2020. © 2024 Elsevier Inc.
Anesthesia and Intensive Care, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy; Queensland University of Technology, Brisbane, Australia; Department of Anesthesiology and Perioperative Medicine, University of Utah, Salt Lake City, UT, United States; Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia; Griffith University School of Medicine, Gold Coast, Australia; Division of Neuroscience Critical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Faculty of Medicine, Department of Clinical Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil; Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada; Cardiac Sciences Program, St. Boniface Hospital, Winnipeg, MB, Canada; Division of Critical Care, University of Cape Town, Cape Town, South Africa; Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia; Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain; University of Queensland, Brisbane, Australia; St Andrew's War Memorial Hospital, UnitingCare Hospitals, Brisbane, Australia; Wesley Medical Research, Brisbane, Australia; School of Medicine, Griffith University, Brisbane, Australia; Al Adan Hospital; Al Ahli Hospital; Al Menshawy General Hospital; Al-Hawari Center of Surgical Speciality; Al-Mouwasat University Hospital - Damascus; Al-Thawra Teaching Hospital in Albayda; Aljufrah Clinical Isolation Center; Allegheny General Hospital; Alexandria Main University Hospital; Alshifa Hospital, Gaza; Assiut University Hospital; Atbara Teaching Hospital; Avera McKennan Hospital & University Health Centre; Barmherzige Bruder Regansburg; Baylor Scott & White Health; Bergamo Hospital; Beth Israel Deaconess Medical Centre; Box Hill Hospital; Caboolture Hospital; Canberra Hospital; Carilion Clinic; Chiba University Graduate School of Medicine; Chonnam National University Hospital; Cleveland Clinic- Abu Dhabi; Cleveland Clinic - Florida; Cleveland Clinic - Ohio; Clinica Alemana De Santiago; Clinica Las Condez; Clinica Pasteur National- University of Comahue; Clinica Valle de Lilli; Medical ICU, Columbia College of Physicians and Surgeons, New-York-Presbyterian Hospital, NY, NY, United States; Dr. Mohammad Alfagih Hospital; Dr Sulaiman Alhabib Medical Group – Research Center, Riyadh, Saudi Arabia; Emory University Healthcare System; Fatmawati Hospital; Fondazione IRCCS Policlinico of Milan (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico); Fondazione Policlinico Universitario Agostino Gemelli IRCCS; Fujieda Municipal General Hospital; Fukuoka University; Fundación Cardiovascular de Colombia; Galway University Hospitals; Geelong Hospital; Gheryan Central Hospital; Glenfield Hospital; Gold Coast University Hospital; Groote Schuur Hospital; Hamad General Hospital - Weill Cornell Medical College in Qatar; Hartford HealthCare; Hasan Sadikin Hospital (Adult); Hiroshima University; Hospital Alemán; Hospital Civil Marie Curie; Hospital Clinic, Barcelona; Hospital de Clínicas; Hospital del Tórax; Hospital du Sacre Coeur (Universite de Montreal); Hospital Emergencia Ate Vitarte; Hospital Mater Dei; Hospital Nuestra Señora de Gracia; Hospital Puerta de Hierro; Hospital Universitari Sagrat Cor; Hospital Universitario Sant Joan d'Alacant; Hospital Universitario Virgen de Valme; Hospital Verge de la Cinta de Tortosa; Houston Methodist Hospital; INCOR (Universidade de São Paulo); INOVA Fairfax Hospital; ISMETT; Jabra Hospital, Khartoum, Sudan; Johns Hopkins; Kafr Elsheikh University Hospital; Kakogawa Acute Care Medical Center; Keimyung University Dong San Hospital; Kimitsu Chuo Hospital; Klinikum Passau; Kouritu Tousei Hospital; Al-Amiri and Jaber Al-Ahmed Hospitals, Kuwait Extracorporeal Life Support Program; Kyoto Medical Centre; Kyoto Prefectural University of Medicine; Kyung Pook National University Chilgok Hospital; Lancaster General Health; Lankenau Institute of Medical Research (Main Line Health); Launceston General Hospital; Le Bonheur Children's Hospital; Le Molinette Hospital (Ospedale Molinette Torino); Legacy Emanuel Medical Center; London Health Sciences Centre; Maastricht University Medical Centre; Manipal Hospital Whitefield; Mansoura University Hospital; Hospital Privado de Comunidad. Mar del Plata. Escuela Superior de Medicina. Universidad Nacional de Mar del Plata; Maroondah Hospital; Mater Misericordiae University Hospital; Mayo Clinic College of Medicine; McGill University Health Centre; Medical College of Wisconsin (Froedtert Hospital); Medical University of Vienna; Medical Department II, LMU Hospital Munich; MedStar Washington Hospital Centre; Misurata Medical Center; Monash University; Mount Sinai Medical Centre; Nagoya University Hospital; National Cardiovascular Center Harapan Kita, Jakarta, Indonesia; National Taiwan University Hospital; Nasar City Hospital for Insurance; Nemours Alfred I duPont Hospital for Children; NMC Al Nahda Hospital Dubai; NMC Royal Hospital, Abu Dhabi, United Arab Emirates; North Estonia Medical Centre; Northwell Health; Obihiro-Kosei General Hospital; Ochsner Clinic Foundation; Ohio State University Medical Centre; Oklahoma Heart Institute; Oregon Health and Science University Hospital (OHSU); Ospedale di Arco (Trento Hospital); Ospedale San Gerardo; Ospedale San Paolo; Padua University Hospital (Policlinico of Padova); Pamela Youde Nethersole Eastern Hospital; Papworth Hospitals NHS Foundation Trust; Penn Medicine (Hospital of the University of Pennsylvania); Persahabatan General Hospital; Perth Children's Hospital; Piedmont Atlanta Hospital; Policlinico di S. Orsola, Università di Bologna; Presbyterian Hospital Services, Albuquerque; Prince Hamza Hospital - Amman; Princess Margaret Hospital; Prof Dr R. D. Kandou General Hospital - Paediatric; Prof Dr R. D R. D. Kandou General Hospital - Adult; Dr Sulianti Saroso Hospital; Providence Saint John's Health Centre; Queen Elizabeth Hospital, Hong Kong; The University of Hong Kong; Redcliffe Hospital; Regdalin Hospital; Rinku General Medical Center (and Senshu Trauma and Critical Care Center); Rio Hortega University Hospital; Rochester General Hospital; Royal Children's Hospital; Royal North Shore Hospital; Royal Prince Alfred Hospital; RSUD Soetomo; Rush University, Chicago; Sabha Medical Center; Saiful Anwar Malang Hospital (Brawijaya University) (Paediatrics); Saiful Anwar Malang Hospital (Brawijaya University) (Adult); Saiseikai Senri Hospital; Saiseikai Utsunomiya Hospital; San Martino Hospital; San Pedro de Alcantara Hospital; Sao Camilo Cura D'ars; São João Hospital Centre, Porto; Sardjito Hospital (Paediatrics); Seoul National University Bundang Hospital; Severance Hospital; Shizuoka Children's Hospital; Sinai Health Systems (Mount Sinai Hospital); Siriraj Hospital; Soug Althulatha Isolation Center; Sozialmedizinisches Zentrum Süd - Kaiser-Franz-Josef-Spital; St Boniface Hospital (University of Mannitoba); St Christopher's Hospital for Children; St George Hospital; St Marianna Medical University Hospital; Stanford University Hospital; St Vincent's Hospital; Swani Health Isolation Center; Tanta University Hospital; Tartu University Hospital; Teine Keijinkai Hospital; The Alfred Hospital; The Heart Hospital Baylor Plano, Plano; The Prince Charles Hospital; The University of Kansas Medical Centre; Tishreen University Hospital; Tohoku Medical and Pharmaceutical University; Tokyo Metropolitan Bokutoh Hospital; Tokyo Metropolitan Medical Center; Toronto General Hospital; Tokyo Women's Medical University Hospital; Tripoli Central Hospital; Tripoli University Hospital; Tufts Medical Centre (and Floating Hospital for Children); Universitätsklinikum Frankfurt (University Hospital Frankfurt) (Uniklinik); Universitätsklinikum Regensburg (Klinik für Innere Medizin II); University Airlangga Hospital (Paediatric); University Hospital Cleveland Medical Centre (UH Cleveland Hospital); University Hospital in Krakow; University Hospitals of Leicester NHS Trust (Glenfield Hospital); University of Alabama at Birmingham Hospital (UAB); University of British Columbia; University of Calgary (Peter Lougheed Centre, Foothills Medical Centre, South Health Campus and Rockyview General Hospital); University of California, San Francisco-Fresno Clinical Research Centre; University of Chicago; University of Cincinnati Medical Centre; University of Florida; University of Iowa; University of Maryland - Baltimore; University of Michigan Medical Center; University of Milan; University of Nebraska Medical Centre; University of Oklahoma Health Sciences Centre (OU); Faculty of Medicine, University of Tripoli; University of Utah Hospital; Vall d'Hebron University Hospital, Barcelona; Washington University in St. Louis/ Barnes Jewish Hospital; Yokohama City University Medical Center; ISARIC, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom; Aberdeen Royal Infirmary (Foresterhill Health Campus); Adam Malik Hospital; Aichi Childrens Health and Medical Center; Ain Shams University; Aleppo University Hospital; Al-Sader Teaching Hospital, Al-Najaf; Al Salam Specialized Hospital; Alshifa Center Medical City; Alshuhada Hospital; American Hospital; Anam Korea University Hospital; Auckland City Hospital; Austin Hospital; Azienda Ospedaliero Universitaria Parma; Banner University Medical Centre; Baptist Health Louisville; Barts Hospital; Benghazi Medical Centre; Benha University Hospital; Beni-Suef University Hospital; Billings Clinic; Brigham and Women's Hospital; Borgo San Lorenzo Hospital; Brighton and Sussex Medical School; Brooke Army Medical Centre; Bundaberg Hospital; Cairo University Hospital; Cardio VID; Careggi Hospital; Cedar Park Regional Medical Center; Cedars-Sinai Medical Centre; Cengkareng Hospital; Centre Hospitalier Universitaire Ibn Sina Rabat; Centro Hospitalar de Lisboa; Charite-Univerrsitatsmedizi n Berlin; Charles Nicolle University Hospital; Children's Health Ireland (CHI) at Crumlin; Children's Hospital Bambino Gesù; Children's Healthcare of Atlanta - Egleston Hospital; Children's Hospital - Los Angeles; Christiana Care Health System's Centre for Heart and Vascular Health; CHU - Chu Saadna Abdenour De Sétif - Sétif; CHU de Charleroi; Chungbuk National University Hospital; Cincinnati Children's; Cipto Mangunkusumo Hospital; Città della Salute e della Scienza Hospital - Turin, Italy; Clínica Sagrada Família; Clinica Universidad de Navarra; Collaborative Centre Department Cardiac Surgery, UZ Leuven; Damascus Hospital; Dignity Health Medical Group- Dominican; Dignity Health St. Joseph's Hospital and Medical Center (SJHMC); Doernbecher Children's Hospital; Donaustauf Hospital; Duke University Hospital (Durham); Elmarj Teaching Hospital; Eunpyeung St Mary's Hospital; Fluminense Federal University; Fundación Clinica Shaio (Shaio Clinic); Gdansk Medical University; General University Hospital; George Washington University Hospital; Gharyan Central Hospital; Giesinger Medical Centre; Giza International Hospital; Gunma University Graduate School of Medicine; Guy's and St Thomas NHS Foundation Trust Hospital; Hakodate City Hospital; Hallym University Sacred Heart Hospital; Hamilton General Hospital; Hasan Sadikin Hospital (Paediatric); Heart Institute Ministry of Health of Ukraine; Heim Pál National Pediatric Institute; Hervey Bay Hospital; Hospital Clinico de la Pontificia Universidad Catolica; Hospital Clinico de la Universidad de Chile; Hospital de Clínicas de Porto Alegre; Hospital Felicio Rocho; Hospital Israelita Albert Einstein; Hospital Privado de Comunidad; Hospital Pro Cardíaco; Hospital Punta de Europa; Hospital Regional de Valdivia; Hospital Samaritano Paulista; Hospital Santa Catarina; Hospital Santa Marta; Hospital Sirio Libanes; Hospital Universitario de Bellvitge; Hospital Universitario Esperanza (Universidad Francisco Marroquin); Hospital Universitario Lucus Augusti; Hyogo Prefectural Kobe Children's Hospital; Ibn Al-Nafees Hospital; Indiana University Health; Inselspital University Hospital; Institut Universitaire de Cardiologie et de Pneumologie de Quebec - Universite Laval; Instituto de Cardiologia do Distrito Federal - ICDF; Instituto de Medicina Integral . Fernando Figueira (IMIP); Instituto Goiano de Diagnostico Cardiovascular (IGDC); INTEGRIS Baptist Medical Center; Japan Red Cross Maebashi Hospital; John C Lincoln Medical Centre; John Hunter Hospital; Jordan University Hospital; Kalamoon Hospital; Kariadi Hospital Semarang; Kenyatta National Hospital (KNH); King Abdullah Medical City; King Abdullah Medical City Specialist Hospital; King Abdullah Medical Complex; King Salman Hospital NWAF; King Saud Medical City; KK Women's and Children's Hospital; KKR Medical Center; Kyung Pook National University Hospital; Lagos University Teaching Hospital; Lung Center of the Philippines; Luxembourg Heart Center; M Health Fairview; Maine Medical Centre (Portland Maine); Manchester University NHS Foundation Trust - Wythenshawe; Massachusetts General Hospital; Medanta Hospital; Medica Super speciality Hospital; Medical University of South Carolina; Mediclinic Parkview Hospital Dubai; Memorial Hermann - Texas Medical Centre; Memorial Regional Hospital (Hollywood Florida); Mercy Hospital of Buffalo; Mie University Hospital; Mohammed VI University Hospital; National Centre for Infectious Diseases; National Cerebral and Cardiovascular Center; National Kidney and Transplant Institute; National University Hospital, Singapore; National University of Comahue; Nelson Mandela Children's Hospital; Nepean Hospital; Netcare Unitas ECMO Centre; Nippon Medical School Hospital; Northwestern Medicine; Norton Children's Hospital; Novant Health (NH) Presbyterian Medical Centre; Ochsner LSA Health Shreveport; Okayama University Hospital; Open Heart 5th Clinical Hospital, Tbilisi; Osaka City General Hospital; Ospedale Gaslini; Ospedali dei Colli; Paracelsus Medical University Nuremberg; Parirenyatwa General Hospital; Pediatric and Neonatal Cardiac Intensive Care at the American University; Pelni Hospital; Penn State Heath S. Hershey Medical Centre; Peyton Manning Children's Hospital; Policlinico Umberto, Sapienza University of Rome; Presbyterian Hospital, New York/ Weill Cornell Medical Centre; Preventive Medicine Hospital; Prince Hamza Hospital- Amman; Prince Mohammed bin Abdulaziz Hospital; Prince of Wales; Providence Sacred Heart Children's Hospital; Queen Elizabeth II University Hospital; Queensland Children's Hospital; Queens University of Belfast; Rabat University Hospital; Radboud University Medical Centre; Rafidia Surgical Hospital; Rambam Hospital; Ramón y Cajal University Hospital; Rapha Medical Centre; Redcliffe Hospital.; Rockhampton Hospital; Royal Adelaide Hospital; Royal Brompton & Harefield NHS Foundation Trust; Royal Columbian Hospital; Royal Infirmary Edinburgh; Sahlgrenska University Hospital; Saiseikai Yokohamashi Tobu Hospital; San Martino Hospital.; Sanglah General Hospital; Santa Casa de Misericordia de Juiz de Fora; Santa Casa de Misericórdia de Vitoria; Sardjito Hospital; Scripps Memorial Hospital La Jolla; Seoul National University Children's Hospital; Seoul National University Hospital; Sheba Medical Center; Sherbin General Hospital; Shimane University Hospital; Soba University Hospital; Soetomo General Hospital (FK UNAIR); Souad Kafafi University Hospital; Spectrum Health Western Governors University; St. Antonius Hospital; St James's University Hospital; Stony Brook University; Suat Seren Chest Diseases and Surgery Practice and Training Centre; Suez Canal University Hospitals; Swansea Hospital; Tan Tock Seng Hospital; The Catholic University of Seoul St Mary Hospital; The Christ Hospital; The Medical Centre Navicent Health; Thomas Jefferson University Hospital; Tohoku University; Traghen Hospital; Tuen Mun Hospital; UCLA Medical Centre (Ronald Regan); Universitätsspital Bern, Universitätsklinik für Herz- und Gefässchirurgie; Universite Libre de Bruxelles; University Airlangga Hospital (Adult); University de Montreal (Montreal Heart Institute); University Hospital CHLN; University Hospital Dubrava; University Hospital Leuven; University Medical Center Groningen; University of Aberta (Mazankowski Heart Institute); University of Antwerp; University of Calgary and Alberta Health Services; University of California at San Diego; University of California, Irvine; University of Kentucky Medical Center; University of Missouri; University of Pittsburgh Medical Centre; University of Rochester Medical Centre (UR Medicine); University of South Carolina; University of Texas Medical Branch; University of the Ryukyus; University of Washington in Seattle; University of Wisconsin & American Family Children's Hospital; UTHealth (University of Texas); UT Southwestern; Valley Children's Hospital (Madera); Vassar Brothers Medical Center (VBMC); Verona Integrated University Hospital; Wahidin Sudirohusodo Hospital; WellSpan Health - York Hospital; Westmead Hospital; Yale New Haven Hospital; Zagazig University Hospital