Silk Road Medical (NSDQ:SILK) posted fourth-quarter results that missed the consensus forecast on Wall Street, citing a second wave of COVID-19 in the last quarter of 2020.

The Sunnyvale, Calif.-based company reported losses of -$16.8 million, or -49¢ per share, on sales of $21.1 million for the three months ended Dec. 31, 2020, for a sales growth of 13.41% compared with Q4 2019.

Earnings per share were -49¢, 21¢ behind The Street, where analysts were looking for sales of $21.4 million.

“Throughout 2020, we made meaningful progress on our strategic, market development, and commercial goals which is a testament to the tenacity of our team and the underlying demand for TCAR,” president and CEO Erica Rogers said in a news release. “We are well-positioned for growth and success in 2021 and beyond, as we work to drive deeper physician adoption and further expand our total addressable market.”

Rogers said the resurgence of COVID-19 in Q4 contributed to its quarterly results.

“As we indicated in January, we entered the fourth quarter of 2020 aware of the potential for a resurgence in the pandemic and that came to bear in the latter part of the quarter,” Rogers said during an earnings call. “With hospital resources pressured, specifically, staff, labor and ICU beds, we started to see constraints on elective procedures. That said, for patients with severe carotid artery disease, stroke prevention can only be delayed so long. All-in, this translated into solid fourth-quarter results in spite of the worsening environment.”

Silk Road Medical projects full-year 2021 revenue to be in the range of $102 million to $108 million.

Shares in SILK were up 0.97% to $55.30 apiece at market close and were at a standstill after hours.