Acute stroke management pathway during Coronavirus-19 pandemic

Area of Science:

• Neurology
• Public Health
• Infectious Diseases

Background:

• The COVID-19 pandemic presented significant challenges to healthcare systems globally.
• Maintaining specialized stroke units free from COVID-19 transmission was a primary concern.
• Adapting acute stroke management pathways became necessary to ensure patient safety.

Purpose of the Study:

• To share experiences and highlight challenges in managing acute stroke during the COVID-19 pandemic.
• To emphasize the importance of continued vigilance for stroke as an emergency condition.
• To report changes in stroke patient presentation and treatment times.

Main Methods:

• Implementation of a dedicated COVID-19 pre-triage hot-spot.
• Utilization of a mobile CT unit for COVID-19 positive or suspected patients.
• Establishment of dedicated areas for COVID-19 patients through interdisciplinary collaboration.

Main Results:

• A substantial change in the acute stroke management pathway was observed.
• A decrease in patients presenting with minor strokes and transient ischemic attacks (TIAs).
• Increased onset-to-door and door-to-treatment times for major strokes.
• A reduction in patient transfers from spoke hospitals.

Conclusions:

• The adapted stroke pathway was tested and validated during the pandemic.
• There is a critical need to maintain high attention on stroke as an emergency.
• Patients experiencing stroke symptoms should not delay seeking medical attention due to COVID-19 concerns.