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Infectious Disease: COVID-19

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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

Impact of the COVID-19 pandemic on stroke epidemiology and clinical stroke practice in the US
: To examine the impact of the COVID-19 pandemic on stroke, the number of stroke patients, time since last known well (LKW), morbidity, and mortality of stroke patients in Southwest Healthcare System (SHS), California (CA) and the United States (US) were analyzed during 2019 and compared to 2020. Our hypothesis is that there are regional differences in stroke outcome depending on location during the COVID-19 study period which influences stroke epidemiology and clinical stroke practice.
Source: Journal of Stroke and Cerebrovascular Diseases - January 26, 2021 Category: Neurology Authors: Daniel Friedlich, Tali Newman, Stephanie Bricker Source Type: research

Addressing stroke admissions during COVID-19 pandemic beyond fear and constraining health factors
We read with great interest the recently published paper by Candelaresi et al1 addressing the impact of Covid-19 lockdown on stroke admissions. The manuscript further consolidates the evidence that COVID-19 pandemic has an impact on stroke admissions and the associated quality of care1 –4. Similar to previous studies2,3, fear of exposure to coronavirus was considered to be an important driver to the reduction of stroke admission. Although the reduction of stroke admissions during COVID-19 was proposed to be driven predominantly by decrease of admission of less severe stroke pati ents3,4, there are evidence showing that t...
Source: Journal of Stroke and Cerebrovascular Diseases - February 26, 2021 Category: Neurology Authors: Hip ólito Nzwalo, Nicola Logallo Tags: Letter to the Editor Source Type: research

Feasibility of a remotely supervised home-based group eHealth Fitness and Mobility Exercise program for stroke: French-Canadian version preliminary study
CONCLUSION: FAME@home was feasible to deliver as a remotely supervised group exercise program to community-dwelling stroke survivors, with high levels of retention and adherence. FAME@home improved accessibility to exercise and facilitated engagement by having a class schedule and social interaction.PMID:34994303 | DOI:10.1080/10749357.2021.2012008
Source: Topics in Stroke Rehabilitation - January 7, 2022 Category: Neurology Authors: Marie-Andr e Gagnon Charles S biyo Batcho Marie-Louise Bird Benoit Labb Krista L Best Source Type: research

Best Practice Recommendations for Stroke Vascular Imaging During Iodinated Contrast Shortage
GE Healthcare© announced on April 19, 2022, that their main factory and distributor of iodinated contrast had experienced a temporary shutdown because of COVID-19 outbreak in Shanghai, China. This, along with other supply chain issues, led to a worldwide shortage of iodinated contrast agents, Omnipaque and Visipaque. Our Comprehensive Stroke Center was confronted with the cascading effect of this iodinated contrast material shortage. We took immediate steps to revise our protocols and processes to continue to provide high-quality care to our stroke patients. A multidisciplinary working group comprised of representativ...
Source: Neurology Clinical Practice - March 3, 2023 Category: Neurology Authors: Bhole, R., Solenski, N. J., Donahue, J. H., Kellogg, R. T., Roach, N. N., Chapman, S. N., Worrall, B. B., Evans, A. J., Patel, S. H., Mukherjee, S., Park, M. S., Southerland, A. M. Tags: Decision analysis, Medical care, All Cerebrovascular disease/Stroke, All Practice Management Commentary Source Type: research

Current Recommendations for the Management of Stroke Patients in the Middle East in the Era of COVID-19 Pandemic; Statement from the MENA SINO
COVID-19 pandemic has led to a change in the way we manage acute medical illnesses. This pandemic had a negative impact on stroke care worldwide. The World Stroke Organization (WSO) has raised concerns due to the lack of available care and compromised acute stroke services globally. The numbers of thrombolysis and thrombectomy therapies are declining. As well as, the rates and door-to treatment times for thrombolysis and thrombectomy therapies are increasing. The stroke units are being reallocated to serve COVID-19 patients, and stroke teams are being redeployed to COVID-19 centers.
Source: Journal of Stroke and Cerebrovascular Diseases - July 21, 2020 Category: Neurology Authors: Amal Al Hashmi, Atilla Ozcan Ozdemir, Ashfaq Shuaib, Hosam AlJehani, Ossama Mansour, Adel Alhazzani, Farid Aladhem, Mehdi Farhoudi, Seby John, Maher Saqqur Source Type: research

Integrating New Staff into Endovascular Stroke-Treatment Workflows in the COVID-19 Pandemic INTERVENTIONAL
SUMMARY: A health care crisis such as the coronavirus disease 2019 (COVID-19) pandemic requires allocation of hospital staff and resources on short notice. Thus, new and sometimes less experienced team members might join the team to fill in the gaps. This scenario can be particularly challenging in endovascular stroke treatment, which is a highly specialized task that requires seamless cooperation of numerous health care workers across various specialties and professions. This document is intended for stroke teams who face the challenge of integrating new team members into endovascular stroke-treatment workflows during the...
Source: American Journal of Neuroradiology - January 11, 2021 Category: Radiology Authors: Goyal, M., Kromm, J., Ganesh, A., Wira, C., Southerland, A., Sheth, K. N., Khosravani, H., Panagos, P., McNair, N., Ospel, J. M., On behalf of the AHA/ASA Stroke Council Science Subcommittees: Emergency Neurovascular Care (ENCC), the Cardiovascular and St Tags: INTERVENTIONAL Source Type: research

Inequities in Telemedicine Use Among Patients With Stroke and Cerebrovascular Diseases: A Tricenter Cross-sectional Study
Discussion In our diverse cohort across 3 centers, we found differences in TM visit type by race and insurance early during the COVID-19 pandemic. These findings suggest disparities in VTM access across different stroke populations. As VTM remains an integral part of outpatient neurology practice, steps to ensure equitable access are essential.
Source: Neurology Clinical Practice - March 14, 2023 Category: Neurology Authors: Naqvi, I. A., Cohen, A. S., Kim, Y., Harris, J., Denny, M. C., Strobino, K., Bicher, N., Leite, R. A., Sadowsky, D., Adegboye, C., Okpala, N., Okpala, M., Savitz, S. I., Marshall, R. S., Sharrief, A. Tags: All Health Services Research, All Cerebrovascular disease/Stroke, Underserved populations, Health disparities Research Article Source Type: research

COVID-19-Related Stroke
AbstractThe COVID-19 pandemic is associated with neurological symptoms and complications including stroke. There is hypercoagulability associated with COVID-19 that is likely a “sepsis-induced coagulopathy” and may predispose to stroke. The SARS-CoV-2 virus binds to angiotensin-converting enzyme 2 (ACE2) present on brain endothelial and smooth muscle cells. ACE2 is a key part of the renin angiotensin system (RAS) and a counterbalance to angiotensin-converting enzyme 1 (ACE1) and angiotensin II. Angiotensin II is proinflammatory, is vasoconstrictive, and promotes organ damage. Depletion of ACE2 by SARS-CoV-2 may tip the...
Source: Translational Stroke Research - May 6, 2020 Category: Neurology Source Type: research

A protocol for acute stroke unit care during the COVID-19 pandemic
Limited resources, manpower shortages, tight infection control, physical distancing regulations and stay-at-home policies, we are all adapting our systems to care for stroke patients during this challenging time. There are different phases in the care of stroke patients and these may overlap; hyperacute care often involving reperfusion treatments, acute stroke unit (ASU) management as an inpatient and subsequently rehabilitation focus in an inpatient or outpatient setting. There have been reports providing guidance and protocols for hyperacute reperfusion treatment provision such as the management of stroke activations, co...
Source: Journal of Stroke and Cerebrovascular Diseases - June 4, 2020 Category: Neurology Authors: Deidre Anne De Silva, Tan Il Fan, Shamala D/O Thilarajah Tags: Original Article Source Type: research

Acute Stroke Care in a New York City Comprehensive Stroke Center during the COVID-19 Pandemic
The coronavirus disease-2019 (COVID-19) pandemic caused unprecedented demand and burden on emergency health care services in New York City. We aim to describe our experience providing acute stroke care at a comprehensive stroke center (CSC) and the impact of the pandemic on the quality of care for patients presenting with acute ischemic stroke (AIS).
Source: Journal of Stroke and Cerebrovascular Diseases - June 19, 2020 Category: Neurology Authors: Shashank Agarwal, Erica Scher, Nirmala Rossan-Raghunath, Dilshad Marolia, Mariya Butnar, Jose Torres, Cen Zhang, Sun Kim, Matthew Sanger, Kelley Humbert, Omar Tanweer, Maksim Shapiro, Eytan Raz, Erez Nossek, Peter K. Nelson, Howard A. Riina, Adam de Haven Source Type: research

Collateral damage – Impact of a pandemic on stroke emergency services
The COVID-19 pandemic's impact on stroke care is two-fold direct impact of the infection and indirect impact on non-COVID-19 diseases. Anecdotal evidence and clinical observation suggest that there is a decrease in the number of patients presenting with stroke during the pandemic. We aim to understand the impact of the COVID-19 pandemic on the utilization of stroke emergency services on a single comprehensive stroke center (CSC).
Source: Journal of Stroke and Cerebrovascular Diseases - July 15, 2020 Category: Neurology Authors: Shashvat M. Desai, Francis X. Guyette, Christian Martin-Gill, Ashutosh P. Jadhav Source Type: research

Early speech-language rehabilitation for stroke patients during the Covid-19 outbreak
This article emphasizes the importance of maintaining a high standard quality of care for patients with acute stroke even if usual practices will have to be modified. Authors include rehabilitation as an integral part of stroke recovery. We strongly support this position: in this letter we would like to share our experience of delivering. speech-language rehabilitation for stroke inpatients during the Covid-19 outbreak.
Source: Journal of Stroke and Cerebrovascular Diseases - July 30, 2020 Category: Neurology Authors: Patrizia Mammi, Chiara Bidini, Elena Ablondi, Maria Rosaria David, Rodolfo Brianti Source Type: research