Patterns of Stroke Management During the Covid – 19 Pandemic: A Systematic Review

Abstract

Background: The Covid-19 pandemic is an unpresented worldwide health emergency that has totally changed how the medical community treat patients with stroke.  Deviation from the usual pathways on stroke management has become the collateral damage of this pandemic.  This present review summarizes the impact of the Covid-19 pandemic on stroke care.

Methods: The research question was answered with a systematic literature and results were summarized narratively.  A literature search in the databases PubMed, Google Scholar, ProQuest, Cochrane Library, Embase, Web of Science, CIHNL, Open Grey, Grey Net and PROSPERO between 2019 to August 2020 was performed.  Three authors reviewed the full texts of potentially relevant studies to determine their eligibility for inclusion. 

Results: 14 studies were included in this review.  There was a delay in hospital presentation, door-to-needle time and door-to-imaging time in the process flow of stroke management during the pandemic.  There was also a decrease in the number of admissions, rate of IV thrombolysis, mechanical thrombectomy and rehabilitation referrals.

Conclusions: The Covid-19 pandemic has totally changed how patients with acute stroke are managed.  There is a need to devise ways to circumvent this problem to maximize patient recovery without compromising patient safety.

Keywords: Stroke, cerebrovascular accident, ischemic stroke, hemorrhagic stroke, Covid-19, SARS-Cov 2, Corona virus