Adnan I Qureshi1, Foad Abd-Allah2, Fahmi Al-Senani3, Emrah Aytac4, Afshin Borhani-Haghighi5, Alfonso Ciccone6, Camilo R Gomez7, Erdem Gurkas8, Chung Y Hsu9, Vishal Jani10, Liqun Jiao11, Adam Kobayashi12, Jun Lee13, Jahanzeb Liaqat14, Mikael Mazighi15, Rajsrinivas Parthasarathy16, Thorsten Steiner17, M Fareed K Suri18, Kazunori Toyoda19, Marc Ribo20, Fernando Gongora-Rivera21, Jamary Oliveira-Filho22, Guven Uzun23, Yongjun Wang24. 1. Zeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO, USA. 2. Department of Neurology, Kasralainy school of Medicine, Cairo University, Cairo, Egypt. 3. Neurology Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia. 4. Department of Neurology, University of FIRAT, Elazig Turkey. 5. Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. 6. Department of Neurosciences, Hospital Carlo Poma, ASST di Mantova, Mantua, Italy. 7. Department of Neurology, University of Missouri, MO, USA. 8. Stroke Center, Department of Neurology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey. 9. Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan. 10. Department of Neurology, Creighton University Medical Center/CHI Health, Omaha, NE, USA. 11. Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China. 12. Department of Neurology and Interventional Stroke Treatment Centre, Kazimierz Pulaski University of Technology and Humanities, Radom, Poland. 13. Department of Neurology, Yeungnam University School of Medicine, Daegu, Korea. 14. Pakistan Emirates Military Hospital (J.L.), Rawalpindi, Pakistan. 15. Department of Interventional Neuroradiology, Rothschild Foundation Hospital, University of Paris, Laboratory of Vascular Translational Sciences, Paris, France. 16. Stroke & Neurointervention Artemis Hospitals, Gurugram, India. 17. Department of Neurology, Klinikum Frankfurt Höchst, Frankfurt and Heidelberg University Hospital, Heidelberg, Germany. 18. St Cloud Hospital, St Cloud, MN, USA. 19. Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 20. Department of Neurology, Hospital Vall d'Hebron, Universitat Autonoma de Barcelona, Spain. 21. Servicio de Neurología, Hospital Universitario José Eleuterio González de la Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México; Instituto de Neurología y Neurocirugía, Hospital Zambrano Hellion, Tecnológico de Monterrey, San Pedro, Nuevo León, México. 22. Department of Biomorphology, Federal University of Bahia, Salvador, Brazil. 23. Beverly Hills Pain Institute and Neurology, Beverly Hills, CA, USA. 24. Tiantan Comprehensive Stroke Center, Beijing Tiantan Hospital, Capital Medical University Beijing, China.
Abstract
BACKGROUND AND PURPOSE: On 11 March 2020, World Health Organization (WHO) declared the COVID-19 infection a pandemic. The risk of ischemic stroke may be higher in patients with COVID-19 infection similar to those with other respiratory tract infections. We present a comprehensive set of practice implications in a single document for clinicians caring for adult patients with acute ischemic stroke with confirmed or suspected COVID-19 infection. METHODS: The practice implications were prepared after review of data to reach the consensus among stroke experts from 18 countries. The writers used systematic literature reviews, reference to previously published stroke guidelines, personal files, and expert opinion to summarize existing evidence, indicate gaps in current knowledge, and when appropriate, formulate practice implications. All members of the writing group had opportunities to comment in writing on the practice implications and approved the final version of this document. RESULTS: This document with consensus is divided into 18 sections. A total of 41 conclusions and practice implications have been developed. The document includes practice implications for evaluation of stroke patients with caution for stroke team members to avoid COVID-19 exposure, during clinical evaluation and performance of imaging and laboratory procedures with special considerations of intravenous thrombolysis and mechanical thrombectomy in stroke patients with suspected or confirmed COVID-19 infection. CONCLUSIONS: These practice implications with consensus based on the currently available evidence aim to guide clinicians caring for adult patients with acute ischemic stroke who are suspected of, or confirmed, with COVID-19 infection. Under certain circumstances, however, only limited evidence is available to support these practice implications, suggesting an urgent need for establishing procedures for the management of stroke patients with suspected or confirmed COVID-19 infection.
BACKGROUND AND PURPOSE: On 11 March 2020, World Health Organization (WHO) declared the COVID-19 infection a pandemic. The risk of ischemic stroke may be higher in patients with COVID-19 infection similar to those with other respiratory tract infections. We present a comprehensive set of practice implications in a single document for clinicians caring for adult patients with acute ischemic stroke with confirmed or suspected COVID-19 infection. METHODS: The practice implications were prepared after review of data to reach the consensus among stroke experts from 18 countries. The writers used systematic literature reviews, reference to previously published stroke guidelines, personal files, and expert opinion to summarize existing evidence, indicate gaps in current knowledge, and when appropriate, formulate practice implications. All members of the writing group had opportunities to comment in writing on the practice implications and approved the final version of this document. RESULTS: This document with consensus is divided into 18 sections. A total of 41 conclusions and practice implications have been developed. The document includes practice implications for evaluation of stroke patients with caution for stroke team members to avoid COVID-19 exposure, during clinical evaluation and performance of imaging and laboratory procedures with special considerations of intravenous thrombolysis and mechanical thrombectomy in stroke patients with suspected or confirmed COVID-19 infection. CONCLUSIONS: These practice implications with consensus based on the currently available evidence aim to guide clinicians caring for adult patients with acute ischemic stroke who are suspected of, or confirmed, with COVID-19 infection. Under certain circumstances, however, only limited evidence is available to support these practice implications, suggesting an urgent need for establishing procedures for the management of stroke patients with suspected or confirmed COVID-19 infection.
Authors: Majdi Al Qawasmeh; Yaman B Ahmed; Omar A Nsour; Aref A Qarqash; Sami S Al-Horani; Ethar A Hazaimeh; Omar F Jbarah; Ahmed Yassin; Belal Aldabbour; Ahmed Alhusban; Khalid El-Salem Journal: Medicine (Baltimore) Date: 2022-07-01 Impact factor: 1.817
Authors: Joseph Y Chu; Gordon W Moe; Manav V Vyas; Robert Chen; Chi-Ming Chow; Milan Gupta; Yosuf Kaliwal; Maria Koh; Dennis T Ko; Peter P Liu Journal: CJC Open Date: 2022-06-27
Authors: P S Dhillon; K Pointon; R Lenthall; S Nair; G Subramanian; N McConachie; W Izzath Journal: AJNR Am J Neuroradiol Date: 2020-08-20 Impact factor: 3.825
Authors: F Al-Mufti; K Amuluru; R Sahni; K Bekelis; R Karimi; J Ogulnick; J Cooper; P Overby; R Nuoman; A Tiwari; K Berekashvili; N Dangayach; J Liang; G Gupta; P Khandelwal; J F Dominguez; T Sursal; H Kamal; K Dakay; B Taylor; E Gulko; M El-Ghanem; S A Mayer; C Gandhi Journal: AJNR Am J Neuroradiol Date: 2021-04-22 Impact factor: 4.966