Interventional Stroke Care in the Era of COVID-19
The current coronavirus disease (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 has led to immense strain on healthcare systems and workers. Patients with severe symptoms of COVID-19 may also present with acute neurological emergencies such as ischemic stroke. Ischemic...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2020-05-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2020.00468/full |
| _version_ | 1811223743565922304 |
|---|---|
| author | Hisham Salahuddin Alicia C. Castonguay Syed F. Zaidi Syed F. Zaidi Richard Burgess Ashutosh P. Jadhav Mouhammad A. Jumaa Mouhammad A. Jumaa |
| author_facet | Hisham Salahuddin Alicia C. Castonguay Syed F. Zaidi Syed F. Zaidi Richard Burgess Ashutosh P. Jadhav Mouhammad A. Jumaa Mouhammad A. Jumaa |
| author_sort | Hisham Salahuddin |
| collection | DOAJ |
| description | The current coronavirus disease (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 has led to immense strain on healthcare systems and workers. Patients with severe symptoms of COVID-19 may also present with acute neurological emergencies such as ischemic stroke. Ischemic stroke in these patients may result from COVID-19 related complications or decompensation of previously asymptomatic cerebrovascular disorders, or concurrent ischemic stroke from common stroke risk factors in a patient with COVID-19. Acute ischemic stroke patients with large vessel occlusions require emergent triage, intensive care, and mechanical thrombectomy. Management of patients with large vessel occlusions (LVO) requires special considerations in the current pandemic. Physicians must now account for prognosis of severe COVID-19, resource utilization, and risk of infection to healthcare workers when determining eligibility for mechanical thrombectomy (MT). Here, we describe important prognostic factors including age, laboratory, and imaging findings to consider for MT selection and provide suggestions for taking care of patients with LVO and possible or confirmed COVID-19. It is recommended to perform MT in patients within the established guidelines, and consider a conservative approach in cases where there is clinical equipoise to minimize futile reperfusion. Lastly, we describe an illustrative case of a patient with ischemic stroke and COVID-19. |
| first_indexed | 2024-04-12T08:37:35Z |
| format | Article |
| id | doaj.art-8b32cb4c4b2f4554b32ac76558799286 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-12T08:37:35Z |
| publishDate | 2020-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-8b32cb4c4b2f4554b32ac765587992862022-12-22T03:39:58ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-05-011110.3389/fneur.2020.00468550812Interventional Stroke Care in the Era of COVID-19Hisham Salahuddin0Alicia C. Castonguay1Syed F. Zaidi2Syed F. Zaidi3Richard Burgess4Ashutosh P. Jadhav5Mouhammad A. Jumaa6Mouhammad A. Jumaa7Department of Neurology, University of Toledo, Toledo, OH, United StatesDepartment of Neurology, University of Toledo, Toledo, OH, United StatesDepartment of Neurology, University of Toledo, Toledo, OH, United StatesPromedica Neurosciences Center, Toledo, OH, United StatesDepartment of Neurology, University of Toledo, Toledo, OH, United StatesDepartment of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, United StatesDepartment of Neurology, University of Toledo, Toledo, OH, United StatesPromedica Neurosciences Center, Toledo, OH, United StatesThe current coronavirus disease (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 has led to immense strain on healthcare systems and workers. Patients with severe symptoms of COVID-19 may also present with acute neurological emergencies such as ischemic stroke. Ischemic stroke in these patients may result from COVID-19 related complications or decompensation of previously asymptomatic cerebrovascular disorders, or concurrent ischemic stroke from common stroke risk factors in a patient with COVID-19. Acute ischemic stroke patients with large vessel occlusions require emergent triage, intensive care, and mechanical thrombectomy. Management of patients with large vessel occlusions (LVO) requires special considerations in the current pandemic. Physicians must now account for prognosis of severe COVID-19, resource utilization, and risk of infection to healthcare workers when determining eligibility for mechanical thrombectomy (MT). Here, we describe important prognostic factors including age, laboratory, and imaging findings to consider for MT selection and provide suggestions for taking care of patients with LVO and possible or confirmed COVID-19. It is recommended to perform MT in patients within the established guidelines, and consider a conservative approach in cases where there is clinical equipoise to minimize futile reperfusion. Lastly, we describe an illustrative case of a patient with ischemic stroke and COVID-19.https://www.frontiersin.org/article/10.3389/fneur.2020.00468/fullCOVID-19strokepandemicthrombectomyischemiccoronavirus |
| spellingShingle | Hisham Salahuddin Alicia C. Castonguay Syed F. Zaidi Syed F. Zaidi Richard Burgess Ashutosh P. Jadhav Mouhammad A. Jumaa Mouhammad A. Jumaa Interventional Stroke Care in the Era of COVID-19 Frontiers in Neurology COVID-19 stroke pandemic thrombectomy ischemic coronavirus |
| title | Interventional Stroke Care in the Era of COVID-19 |
| title_full | Interventional Stroke Care in the Era of COVID-19 |
| title_fullStr | Interventional Stroke Care in the Era of COVID-19 |
| title_full_unstemmed | Interventional Stroke Care in the Era of COVID-19 |
| title_short | Interventional Stroke Care in the Era of COVID-19 |
| title_sort | interventional stroke care in the era of covid 19 |
| topic | COVID-19 stroke pandemic thrombectomy ischemic coronavirus |
| url | https://www.frontiersin.org/article/10.3389/fneur.2020.00468/full |
| work_keys_str_mv | AT hishamsalahuddin interventionalstrokecareintheeraofcovid19 AT aliciaccastonguay interventionalstrokecareintheeraofcovid19 AT syedfzaidi interventionalstrokecareintheeraofcovid19 AT syedfzaidi interventionalstrokecareintheeraofcovid19 AT richardburgess interventionalstrokecareintheeraofcovid19 AT ashutoshpjadhav interventionalstrokecareintheeraofcovid19 AT mouhammadajumaa interventionalstrokecareintheeraofcovid19 AT mouhammadajumaa interventionalstrokecareintheeraofcovid19 |