Novel coronavirus may increase stroke risk in certain patients, and it may be first symptom, according to a neurologist from the university of Missouri health care. 40 new recommendations have been published to evaluate and treat stroke patients based on international research examining the link between stroke and novel coronavirus (COVID-19).
‘The purpose of new recommendations is to provide an easy guide on how to manage patients who presented with stroke in the emergency department.’
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Neurologist Adnan I. Qureshi, MD, a professor of clinical neurology at the MU School of Medicine, led a team of stroke experts from 18 countries with documented COVID-19 outbreaks to develop recommendations for doctors evaluating patients with acute ischemic stroke who have either suspected or confirmed COVID-19 infection.Read More..
The international panel noted increased clotting in COVID-19 patients, which raised their risk for stroke. The research team found evidence that young people without previous risk factors for stroke are experiencing ischemic stroke with clots in the arteries of the brain presumably related to a COVID-19 infection. The average onset of stroke in COVID-19 patients occurred 10 days after infection, but in some cases, stroke was the initial symptom.
"People may come to the emergency department with stroke, and that may be the initial manifestation of COVID-19 infection, which puts a clear burden on providers because now you may not know if the patient you are evaluating for stroke may actually have underlying COVID-19 infection," Qureshi said.
"The purpose of these recommendations is to provide a step-by-step guide of how to manage these patients. The modifications we suggest have implications for the health of patients, but also the health of those who are involved in their care."
Qureshi's research indicates health care workers are at risk of acquiring COVID-19 from stroke patients and they should take safety precautions while limiting the number of care providers who have direct interaction with each patient.
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"Since COVID-19 actually involves the lungs, a simultaneous scan of the chest and brain can check for stroke and identify changes in the lungs that may identify whether this patient truly has or does not have COVID-19 infection," Qureshi said. "This step has been incorporated into acute stroke protocol at MU Health Care."
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If a COVID-19 infection is confirmed and other organs have been affected, guidelines suggest a Sequential Organ Failure Assessment (SOFA) can provide an overall prognosis before determining the appropriate stroke treatment in COVID-19 patients.
Qureshi's study, "Management of acute ischemic stroke in patients with COVID-19 infection: Report of an international panel," also featured contributions from MU Health Care neurologist Camilo R. Gomez, MD, professor of clinical neurology at the MU School of Medicine. It was recently published by the International Journal of Stroke.
Source-Eurekalert