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Early impact of the COVID-19 pandemic on acute stroke treatment delays.
Abstract This is an observational cohort study comparing 156 patients evaluated for acute stroke between March 30th and May 31st 2020 at a comprehensive stroke center with 138 patients evaluated during the corresponding time period in 2019. During the pandemic, the proportion of COVID- 19 positive patients was low (3%), the time from symptom-onset to hospital presentation was significantly longer, and a smaller proportion of patients underwent reperfusion therapy. Among patients directly evaluated at our institution, door-to-needle and door-to-recanalization metrics were significantly longer. Our findings support ...
Source: The Canadian Journal of Neurological Sciences - July 22, 2020 Category: Neurology Authors: Neves Briard J, Ducroux C, Jacquin G, Alesefir W, Boisseau W, Daneault N, Deschaintre Y, Eneling J, Gioia LC, Iancu D, Odier C, Raymond J, Roy D, Stapf C, Weill A, Poppe AY Tags: Can J Neurol Sci Source Type: research

Code Stroke patient referral by Emergency Medical Services during the public COVID-19 pandemic lockdown
During the coronavirus disease 2019 (COVID-19) pandemic the use of health care systems changed suddenly. Hospitals were overwhelmed as a result of the staggering COVID-19 patient numbers1 and/or modified their daily routine due to prophylactic allocation of resources.2 Public lockdowns with strict containment recommendations for the community have been announced around the world.3 Emergency Medical Services (EMS) and dispatch centers were confronted with increasing numbers of patients/calls and reorganization of the dispatch system including Code Stroke patient referral.
Source: Journal of Stroke and Cerebrovascular Diseases - July 20, 2020 Category: Neurology Authors: Benno Ikenberg, Bernhard Hemmer, Michael Dommasch, Karl-Georg Kanz, Silke Wunderlich, Benjamin Knier Source Type: research

COVID-19 AND STROKE: Experience in a GHANAIAN healthcare system
Background:The novel coronavirus disease 19 (COVID-19) causes multi-system disease including possibly heightened stroke risk. Data from high-income countries (HIC) suggest disruptions to care delivery with reduced stroke admissions and administration of acute stroke reperfusion therapies. We are unaware of any published data on the impact of the COVID-19 pandemic on stroke admissions and outcomes in sub-Saharan Africa.Purpose: To compare rates of stroke admissions and case fatality between corresponding periods in 2020 and 2019, within a hospital system in Ghana, to assess the potential impact of the COVID-19 pandemic.
Source: Journal of the Neurological Sciences - July 14, 2020 Category: Neurology Authors: Fred S. Sarfo, Naa Oboshie Mensah, Francis Agyapong Opoku, Nathaniel Adusei-Mensah, Michael Ampofo, Bruce Ovbiagele Source Type: research

Cerebrovascular disease in patients with COVID-19: neuroimaging, histological and clinical description
We describe pathological and radiological data consistent with thrombotic microangiopathy caused by endotheliopathy with a haemorrhagic predisposition.
Source: Brain - July 9, 2020 Category: Neurology Source Type: research

Risk of Ischemic Stroke in Patients With Coronavirus Disease 2019 (COVID-19) vs Patients With Influenza
This cohort study compares the rate of ischemic stroke among patients with COVID-19 vs patients with influenza in 2 hospitals in New York City, New York.
Source: JAMA Neurology - July 2, 2020 Category: Neurology Source Type: research

COVID-19 Impact on Stroke Presentations
As Covid-19 evolved into a world-wide pandemic, hospitals reported marked declines in strokes, only to be followed by reports of increased numbers of young people presenting with large-vessel occlusions. We reviewed our patient data-base to determine if similar or other novel trends were present.
Source: Journal of Stroke and Cerebrovascular Diseases - June 24, 2020 Category: Neurology Authors: Sheryl Strasser, Laszlo Miskolczi, John Cunha, Lori Justynski Source Type: research

Universal laboratory testing for SARS-CoV-2 in hyperacute stroke during the COVID-19 pandemic
The coronavirus disease 2019 (COVID-19) pandemic necessitates organizational and structural adjustments to local health care systems to protect medical professionals and patients from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (1). Particularly older individuals and those with cardiovascular comorbidities are thought to be at increased risk of COVID-19 (2). Consequently, stroke patients can be considered an at-risk population and might benefit from infection control screens at hospital entry (3,4).
Source: Journal of Stroke and Cerebrovascular Diseases - June 19, 2020 Category: Neurology Authors: Kristian Barlinn, Timo Siepmann, Lars-Peder Pallesen, Simon Winzer, Annahita Sedghi, Percy Schroettner, Kristina Hochauf-Stange, Alexandra Prakapenia, Haidar Moustafa, Katja de With, Jennifer Linn, Heinz Reichmann, Jessica Barlinn, Volker Puetz Tags: Original Article Source Type: research

Acute Stroke Care Algorithm in a Private Tertiary Hospital in the Philippines During the COVID-19 Pandemic: A Third World Country Experience
Since March 2020, we have experienced an influx of COVID-19 positive patients. As of April 27, 2020 the COVID-19 pandemic has claimed the lives of at least 27 healthcare professionals while infecting 1080 healthcare professionals in the Philippines.1 Despite attempts to formalize protocols and treatment pathways to ensure the safety of healthcare professionals while optimizing patient care, Philippine healthcare workers from every department still continue to suffer from COVID-19 infections. These affect not only acute care but also emergency response systems such as the brain attack code.
Source: Journal of Stroke and Cerebrovascular Diseases - June 19, 2020 Category: Neurology Authors: Christian Oliver C. Co, Jeryl Ritzi T. Yu, Cristina Macrohon-Valdez, Lina C. Laxamana, Vincent Paul E. De Guzman, Remy Margarette M. Berroya-Moreno, Manuel M. Mariano, Peter Paul Dela Paz Rivera, Joana Lyn M. Racpan-Cauntay, Karen Czarina S. Ilano, Evita Tags: Original Article Source Type: research

COVID-19: Stroke Admissions, Emergency Department Visits, and Prevention Clinic Referrals.
Abstract We assessed the impact of the coronavirus disease 19 (COVID-19) pandemic on code stroke activations in the ED, stroke unit admissions, and referrals to the stroke prevention clinic at London's regional stroke center, serving a population of 1.8 million in Ontario, Canada. We found a 20% drop in the number of code strokes in 2020 compared to 2019, immediately after the first cases of COVID-19 were officially confirmed. There were no changes in the number of stroke admissions and there was a 22% decrease in the number of clinic referrals, only after the provincial lockdown. Our findings suggest that the dec...
Source: The Canadian Journal of Neurological Sciences - May 25, 2020 Category: Neurology Authors: Bres Bullrich M, Fridman S, Mandzia JL, Mai LM, Khaw A, Vargas Gonzalez JC, Bagur R, Sposato LA Tags: Can J Neurol Sci Source Type: research

Unprotected stroke management in an undiagnosed case of Severe Acute Respiratory Syndrome Coronavirus 2 infection
We report the case of a 79-year-old woman, who was admitted for a wake-up stroke due to occlusion of the left middle cerebral artery. She was treated outside the COVID-19-dedicated track of the hospital because she had no concomitant signs or symptoms suggestive of SARS-CoV-2 infection nor recent contact with other infected individuals.
Source: Journal of Stroke and Cerebrovascular Diseases - May 22, 2020 Category: Neurology Authors: Claudia Papi, Gregorio Spagni, Andrea Alexandre, Paolo Calabresi, Giacomo Della Marca, Aldobrando Broccolini Source Type: research

A Stroke Care Model at an Academic, Comprehensive Stroke Center During the 2020 COVID-19 Pandemic
The COVID-19 pandemic has required the adaptation of hyperacute stroke care (including stroke code pathways) and hospital stroke management. There remains a need to provide rapid and comprehensive assessment to acute stroke patients while reducing the risk of COVID-19 exposure, protecting healthcare providers, and preserving personal protective equipment (PPE) supplies. While the COVID infection is typically not a primary cerebrovascular condition, the downstream effects of this pandemic force adjustments to stroke care pathways to maintain optimal stroke patient outcomes.
Source: Journal of Stroke and Cerebrovascular Diseases - May 6, 2020 Category: Neurology Authors: Dawn Meyer, Brett C. Meyer, Karen S. Rapp, Royya Modir, Kunal Agrawal, Lovella Hailey, Melissa Mortin, Richard Lane, Tamra Ranasinghe, Brian Sorace, Tara D. von Kleist, Emily Perrinez, Mohammed Nabulsi, Thomas Hemmen Source Type: research

Triage of Acute Ischemic Stroke in Confirmed COVID-19: Large Vessel Occlusion Associated With Coronavirus Infection
We present our experience with an in-hospital stroke code called on a COVID-19-positive patient with a left middle cerebral artery syndrome and the challenges faced for timely examination, imaging, and decision to intervene. The outlook for the ongoing COVID-19 pandemic necessitates the development of protocols to sustain timely and effective acute stroke care while mitigating healthcare-associated transmission.
Source: Frontiers in Neurology - April 20, 2020 Category: Neurology Source Type: research

Acute Stroke Care in the Coronavirus Disease 2019 Pandemic
Coronavirus disease 2019 (COVID-19) is a pandemic respiratory disease with serious public health risk, and has taken the world off guard with its rapid spread. As the COVID-19 pandemic intensifies, overwhelming the healthcare system and the medical community, current practice for the management of acute ischemic stroke (AIS) will require modification, and guidelines should be relaxed while maintaining high standard quality of care. The aim of these suggestions is to avoid contributing to the rapid spread of COVID-19 as well as to conserve what are likely to be very limited resources (including personnel, intensive care/hos...
Source: Journal of Stroke and Cerebrovascular Diseases - April 16, 2020 Category: Neurology Authors: Rima M Dafer, Nicholas D Osteraas, Jose Biller MD Source Type: research

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