Acute ischemic stroke with COVID-19: an international consensus statement

  • Qureshi AI & al.
  • Int J Stroke
  • 3 may. 2020

  • de Emily Willingham, PhD
  • Clinical Essentials
El acceso al contenido completo es sólo para profesionales sanitarios registrados. El acceso al contenido completo es sólo para profesionales sanitarios registrados.

Takeaway

  • For patients with acute ischemic stroke and suspected or confirmed COVID-19 infection, clinicians must find a balance between prompt and appropriate treatment vs transmission prevention.
  • A panel consisting of clinicians from more than a dozen countries worldwide has issued a consensus statement, with the caveat that more evidence is needed.

Why this matters

  • Ischemic stroke risk may be higher in people with COVID-19, these authors say, as is the case with other respiratory tract infections.

Key results

  • The consensus statement consists of 18 sections with 41 conclusions and practice implications.
  • Among the conclusions and implications:
    • Evaluation of stroke patients, with cautions for members of the stroke team regarding infectious exposure.
    • Providers should be aware of the high risk of COVID-19 infection, although the exact level of risk increase is not known.
    • Patients with clinically suspected but not confirmed COVID-19 should be evaluated with an assumption of infection.
    • Clinicians should be aware that patients with acute stroke may have undiagnosed COVID-19 but have not been able to access screening or are presymptomatic.
    • Clinicians should do their best to maintain appropriate distance from the patient and/or use suitable personal protective equipment, if available.
    • These authors urge use of Telestroke to allow for virtual evaluations.
  • Other recommendations relate to postadmission procedures specifically, including imaging, and to treatments such as anticoagulation, renal support, and thrombectomy.