Consensus statement – suggested recommendations for acute stroke management during the COVID-19 pandemic: Expert group on behalf of the indian stroke association

Bhatia, Rohit; Sylaja, PN; Srivastava, M V Padma; Khurana, Dheeraj; Pandian, Jeyaraj D.; Suri, Vinit; Kumar, Vijay; Kumaravelu, S; Huded, Vikram; Surya, Nirmal; Sharma, Arvind; Kaul, Subhash

doi:10.4103/aian.aian_302_20

Cited by 34 publications

(43 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…After the first patients with COVID-19 were hospitalized in Singapore [85], Christopher et al [86] provided recommendations for the early recognition and treatment of stroke in patients infected with SARS-CoV-2, including the potential use of intravenous thrombolysis (TPA) or Endovascular Therapy (EVT) with mechanical thrombectomy in COVID-19 patients. A similar consensus was published in India [87].…”

Section: Cerebrovascular Diseasesupporting

confidence: 66%

The neurology of COVID-19 revisited: A proposal from the Environmental Neurology Specialty Group of the World Federation of Neurology to implement international neurological registries

Román

Spencer

Reis

et al. 2020

Journal of the Neurological Sciences

231

249

View full text Add to dashboard Cite

A comprehensive review of the neurological disorders reported during the current COVID-19 pandemic demonstrates that infection with SARS-CoV-2 affects the central nervous system (CNS), the peripheral nervous system (PNS) and the muscle. CNS manifestations include: headache and decreased responsiveness considered initial indicators of potential neurological involvement; anosmia, hyposmia, hypogeusia, and dysgeusia are frequent early symptoms of coronavirus infection. Respiratory failure, the lethal manifestation of COVID-19, responsible for 264,679 deaths worldwide, is probably neurogenic in origin and may result from the viral invasion of cranial nerve I, progressing into rhinencephalon and brainstem respiratory centers. Cerebrovascular disease, in particular large-vessel ischemic strokes, and less frequently cerebral venous thrombosis, intracerebral hemorrhage and subarachnoid hemorrhage, usually occur as part of a thrombotic state induced by viral attachment to ACE2 receptors in endothelium causing widespread endotheliitis, coagulopathy, arterial and venous thromboses. Acute hemorrhagic necrotizing encephalopathy is associated to the cytokine storm. A frontal hypoperfusion syndrome has been identified. There are isolated reports of seizures, encephalopathy, meningitis, encephalitis, and myelitis. The neurological diseases affecting the PNS and muscle in COVID-19 are less frequent and include Guillain-Barré syndrome; Miller Fisher syndrome; polyneuritis cranialis; and rare instances of viral myopathy with rhabdomyolysis. The main conclusion of this review is the pressing need to define the neurology of COVID-19, its frequency, manifestations, neuropathology and pathogenesis. On behalf of the World Federation of Neurology we invite national and regional neurological associations to create local databases to report cases with neurological manifestations observed during the ongoing pandemic. International neuroepidemiological collaboration may help define the natural history of this worldwide problem.

show abstract

Section: Cerebrovascular Diseasesupporting

confidence: 66%

The neurology of COVID-19 revisited: A proposal from the Environmental Neurology Specialty Group of the World Federation of Neurology to implement international neurological registries

Román

Spencer

Reis

et al. 2020

Journal of the Neurological Sciences

231

249

View full text Add to dashboard Cite

show abstract

“…The recent consensus statement of the Indian Stroke Association suggests organizing hospital stroke pathways during the ongoing pandemic. 15 The risk of infectious exposure to clinical teams can be mitigated by adopting the Protected Code Stroke guidelines. 16 Defined and designated areas for all stroke patients and screening by an emergency room physician for suspected COVID-19 symptoms, with full protective gear (full-sleeved gown, surgical mask, eye protection (face shield and/or goggles), gloves, and head cover), have been proposed.…”

Section: Acute Stroke Carementioning

confidence: 99%

The SARS‐CoV‐2/COVID‐19 pandemic and challenges in stroke care in India

Sylaja

Srivastava

Shah³

et al. 2020

Annals of the New York Academy of Sciences

Self Cite

View full text Add to dashboard Cite

Stroke care in India has evolved rapidly in the last decade with a focus on stroke awareness, prevention, rapid triage, treatment, and rehabilitation. But acute stroke care and poststroke rehabilitation in the country have limitations owing to the economic constraints and poor access to health care. The SARS-CoV-2/COVID-19 pandemic has made stroke care even more challenging. We outline the unfavorable circumstances in stroke care induced by the pandemic; propose mitigating measures; crisis management; and provide a comparative evaluation of stroke care between India and the United States during the pandemic. There is a need for public health systems in both developed and developing countries to improve awareness, implement proper strategies of triage, acute treatment, well-defined rehabilitation plans, telemedicine services, and virtual check-ins.

show abstract

“…In effect, the entire system of care may needs to be reorganized (38). Guidelines and suggestions for stroke care have been proposed (39)(40)(41)(42)(43)(44), but each center had best develop its own or tailor existing guidelines to meet and fit its needs. Consent for research, usually performed face-to-face, may be taken remotely (45), either electronically or by phone; follow-ups may need to be by phone (46).…”

Section: Other Solutionsmentioning

confidence: 99%

Stroke Care Services in Singapore During COVID-19 Pandemic—A National Perspective

Venketasubramanian

2020

Front. Neurol.

View full text Add to dashboard Cite

Stroke is a significant cause of admission to Singapore's acute care hospitals. Because of the current COVID-19 pandemic, there have been major changes in the stroke care system. On calling for the public ambulance, those suspected to have COVID-19 infection are taken to the National Center for Infectious Diseases. Otherwise, on arrival at the emergency room, all cases with fever or respiratory symptoms [COVID-19 suspect patients (CSPs)] are evaluated separately by staff wearing full personal protective equipment (PPE). Triage is not delayed. CSPs needing hyperacute therapies are sent to a specially prepared scanner; if not, imaging is deferred to the latter part of the day. CSPs are managed in isolation rooms, and sent to the acute stroke unit (ASU) if two consecutive COVID-19 swabs are negative. Investigation and rehabilitation are done within the room. ASU rounds are attended by essential members, communication by electronic means. Multidisciplinary team rounds have largely ceased, and discussions are via electronic platforms. Patient transfer and staff movement are minimized. All hospital staff wear face-masks, infection control is strictly enforced. Visitors are not allowed; staff make daily calls to update families. Mild stroke patients may be sent home with rehabilitation advice. Outpatient rehabilitation centers are closed. Patients return for outpatient visits only if needed; medications are sent to their home, and nurses make essential home visits. Stroke support and rehabilitation activities have started on-line. Continuing medical education activities are mainly by webinars. Stroke research has been severely hampered. Overall, evidence-based stroke care is delivered in a reorganized manner, with a clear eye on infection control.

show abstract

Consensus statement – suggested recommendations for acute stroke management during the COVID-19 pandemic: Expert group on behalf of the indian stroke association

Cited by 34 publications

References 14 publications

The neurology of COVID-19 revisited: A proposal from the Environmental Neurology Specialty Group of the World Federation of Neurology to implement international neurological registries

The neurology of COVID-19 revisited: A proposal from the Environmental Neurology Specialty Group of the World Federation of Neurology to implement international neurological registries

The SARS‐CoV‐2/COVID‐19 pandemic and challenges in stroke care in India

Stroke Care Services in Singapore During COVID-19 Pandemic—A National Perspective

Contact Info

Product

Resources

About