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Preserving stroke care during the COVID-19 pandemic: Potential issues and solutions.
Leira, Enrique C; Russman, Andrew N; Biller, José; Brown, Devin L; Bushnell, Cheryl D; Caso, Valeria; Chamorro, Angel; Creutzfeldt, Claire J; Cruz-Flores, Salvador; Elkind, Mitchell S V; Fayad, Pierre; Froehler, Michael T; Goldstein, Larry B; Gonzales, Nicole R; Kaskie, Brian; Khatri, Pooja; Livesay, Sarah; Liebeskind, David S; Majersik, Jennifer J; Moheet, Asma M; Romano, Jose G; Sanossian, Nerses; Sansing, Lauren H; Silver, Brian; Simpkins, Alexis N; Smith, Wade; Tirschwell, David L; Wang, David Z; Yavagal, Dileep R; Worrall, Bradford B.
  • Leira EC; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Russman AN; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Biller J; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Brown DL; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Bushnell CD; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Caso V; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Chamorro A; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Creutzfeldt CJ; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Cruz-Flores S; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Elkind MSV; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Fayad P; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Froehler MT; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Goldstein LB; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Gonzales NR; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Kaskie B; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Khatri P; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Livesay S; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Liebeskind DS; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Majersik JJ; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Moheet AM; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Romano JG; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Sanossian N; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Sansing LH; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Silver B; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Simpkins AN; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Smith W; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Tirschwell DL; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Wang DZ; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Yavagal DR; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
  • Worrall BB; From the Departments of Neurology, Neurosurgery & Epidemiology (E.C.L.), University of Iowa, Iowa City, IA; Cerebrovascular Center (A.N.R.), Cleveland Clinic, OH; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (D.L.B.), University of Michigan, Ann
Neurology ; 95(3): 124-133, 2020 07 21.
Article in English | MEDLINE | ID: covidwho-209566
ABSTRACT
The coronavirus 2019 (COVID-19) pandemic requires drastic changes in allocation of resources, which can affect the delivery of stroke care, and many providers are seeking guidance. As caregivers, we are guided by 3 distinct principles that will occasionally conflict during the pandemic (1) we must ensure the best care for those stricken with COVID-19, (2) we must provide excellent care and advocacy for patients with cerebrovascular disease and their families, and (3) we must advocate for the safety of health care personnel managing patients with stroke, with particular attention to those most vulnerable, including trainees. This descriptive review by a diverse group of experts in stroke care aims to provide advice by specifically addressing the potential impact of this pandemic on (1) the quality of the stroke care delivered, (2) ethical considerations in stroke care, (3) safety and logistic issues for providers of patients with stroke, and (4) stroke research. Our recommendations on these issues represent our best opinions given the available information, but are subject to revision as the situation related to the COVID-19 pandemic continues to evolve. We expect that ongoing emergent research will offer additional insights that will provide evidence that could prompt the modification or removal of some of these recommendations.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Quality of Health Care / Coronavirus Infections / Stroke / Delivery of Health Care / Health Services Needs and Demand Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Neurology Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Quality of Health Care / Coronavirus Infections / Stroke / Delivery of Health Care / Health Services Needs and Demand Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Neurology Year: 2020 Document Type: Article