- 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.
- 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.