The SARS‐CoV‐2/COVID‐19 pandemic and challenges in stroke care in India

Sylaja, PN; Srivastava, M. V. Padma; Shah, Sudhir; Bhatia, Rohit; Khurana, Dheeraj; Sharma, Arvind; Pandian, Jeyaraj Durai; Kalia, Kiran; Sarmah, Deepaneeta; Nair, Sruthi S; Yavagal, Dileep R.; Bhattacharya, Pallab

doi:10.1111/nyas.14379

Cited by 41 publications

(45 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, a higher frequency of stroke with unknown etiology was seen during the lockdown (50%), compared with the same period in 2019 (10%). A survey of 13 comprehensive stroke centers in India that was conducted by Sylaja et al [ 138 ] revealed 61%, 64.76%, and 67.21% reduction in the number of stroke admissions, in intravenous thrombolysis, and in neuroendovascular procedures, respectively.…”

Section: Cns Manifestations Associated With Covid-19mentioning

confidence: 99%

Central Nervous System Manifestations Associated with COVID-19

Divani

Andalib

Biller

et al. 2020

Curr Neurol Neurosci Rep

View full text Add to dashboard Cite

Purpose of Review Coronavirus disease 2019 (COVID-19) has become a global health crisis of our time. The disease arises from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that binds to angiotensin-converting enzyme 2 (ACE2) receptors on host cells for its internalization. COVID-19 has a wide range of respiratory symptoms from mild to severe and affects several other organs, increasing the complexity of the treatment. There is accumulating evidence to suggest that SARS-CoV-2 can target the nervous system. In this review, we provide an account of the COVID-19 central nervous system (CNS) manifestations. Recent Findings A broad spectrum of the CNS manifestations including headache, impaired consciousness, delirium, loss of smell and taste, encephalitis, seizures, strokes, myelitis, acute disseminated encephalomyelitis, neurogenic respiratory failure, encephalopathy, silent hypoxemia, generalized myoclonus, neuroleptic malignant syndrome and Kawasaki syndrome has been reported in patients with COVID-19. Summary CNS manifestations associated with COVID-19 should be considered in clinical practice. There is a need for modification of current protocols and standing orders to provide better care for COVID-19 patients presenting with neurological symptoms.

show abstract

Section: Cns Manifestations Associated With Covid-19mentioning

confidence: 99%

Central Nervous System Manifestations Associated with COVID-19

Divani

Andalib

Biller

et al. 2020

Curr Neurol Neurosci Rep

View full text Add to dashboard Cite

show abstract

“…During the pandemic, one major negative impact on acute care for stroke was the decline in emergency hospital admissions, consistent with reports in different regions in China or other countries. The degree of reduction varied from 10 to 70% ( 11 , 13 , 13 , 16 – 19 , 26 – 31 ). One recent report in China also reported a 40% reduction in stroke hospital admissions ( 16 ), similar to our results (45.6%).…”

Section: Discussionmentioning

confidence: 99%

“…Despite these efforts, acute stroke care is still negatively impacted (11)(12)(13)(14)(15). Reductions of 10-70% in stroke hospital admission are reported in several countries (13,(16)(17)(18)(19), though COVID-19 may probably increase the risk of ischemic stroke as a result of endothelial injury and hypercoagulable status and other impacts on the central nervous system (20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

Reductions in Hospital Admissions and Delays in Acute Stroke Care During the Pandemic of COVID-19

Chen

Wang

et al. 2020

Front. Neurol.

View full text Add to dashboard Cite

Background: Rapid and effective medical care for stroke is paramount to achieve maximal functional recovery. Because of the wide spreading of the coronavirus disease in 2019 (COVID-19), acute stroke care is negatively impacted. How much acute care for stroke has been affected during the pandemic remains to be assessed. Methods: The first-level response to major public health was launched from January 24th to April 29th, 2020 in Beijing to contain the spread of COVID-19. Based on a database connecting all 77 stroke centers, the quantity and quality in emergency care for stroke during the 97 lockdown days were compared with the equivalent period in 2019. During the pandemic, 15 of the 77 stroke centers were designated to receive patients sick with COVID-19. Subgroup analyses were carried out by different types of hospitals (designated and undesignated). Results: There were 1,281 and 2,354 stroke emergency hospital admissions in the lockdown period and the parallel period in 2019, respectively. A reduction of 45.6% in admission was shown in the lockdown period, with more reductions for hemorrhagic stroke (69.0%) compared with ischemic stroke (42.9%). More reductions happened in COVID-19 designated hospitals (52.6%) compared with undesignated hospitals (41.8%). The mean NIHSS score at hospital arrival was significantly higher in the lockdown period (9.4 ± 7.7 in 2020 vs. 8.4 ± 7.8 in 2019, P < 0.001). For the metrics measuring the quality of acute stroke care, the onset to door (OTD), onset to needle (ONT), and onset to recanalization (OTR) times didn't change significantly, while significant delays are shown for the door to CT scan (DTC, 1 min delay), door to needle (DTN, 4 min delays), and door to puncture (DTP, 29 min delays) times, which mainly happened in COVID-19 undesignated hospitals. Conclusions: Profound reductions in stroke hospital admissions and significant delays in emergency care for acute ischemic stroke occurred during the pandemic of COVID-19. Engagement and effective communication with all stakeholders including patients, health care providers, governmental policymakers, and other implementation partners are required for future success in similar crises.

show abstract

“…COVID-19 disease is caused by a novel coronavirus (SARS-COV-2) that emerged in the Wuhan province of china [ 1 , 2 ]. The first documented human infection was reported in Dec 2019 and since then, the disease has spread at an unprecedented speed and magnitude to become the greatest healthcare concern of the twenty-first century [ 3 – 5 ].…”

Section: Introductionmentioning

confidence: 99%

Obesity and COVID-19: what makes obese host so vulnerable?

et al. 2021

View full text Add to dashboard Cite

The disease (COVID-19) novel coronavirus pandemic has so far infected millions resulting in the death of over a million people as of Oct 2020. More than 90% of those infected with COVID-19 show mild or no symptoms but the rest of the infected cases show severe symptoms resulting in significant mortality. Age has emerged as a major factor to predict the severity of the disease and mortality rates are significantly higher in elderly patients. Besides, patients with underlying conditions like Type 2 diabetes, cardiovascular diseases, hypertension, and cancer have an increased risk of severe disease and death due to COVID-19 infection. Obesity has emerged as a novel risk factor for hospitalization and death due to COVID-19. Several independent studies have observed that people with obesity are at a greater risk of severe disease and death due to COVID-19. Here we review the published data related to obesity and overweight to assess the possible risk and outcome in Covid-19 patients based on their body weight. Besides, we explore how the obese host provides a unique microenvironment for disease pathogenesis, resulting in increased severity of the disease and poor outcome.

show abstract

The SARS‐CoV‐2/COVID‐19 pandemic and challenges in stroke care in India

Cited by 41 publications

References 22 publications

Central Nervous System Manifestations Associated with COVID-19

Central Nervous System Manifestations Associated with COVID-19

Reductions in Hospital Admissions and Delays in Acute Stroke Care During the Pandemic of COVID-19

Obesity and COVID-19: what makes obese host so vulnerable?

Contact Info

Product

Resources

About