Essays
https://doi.org/10.3325/cmj.2020.61.465
A modified stroke code for acute ischemic strokes during the coronavirus disease-2019 pandemic
Sohil Pothiawala
orcid.org/0000-0002-4789-4326
; Department of Emergency Medicine, Woodlands Health Campus, Singapore
Abstract
Coronavirus disease-2019 (COVID-19) was initially believed to manifest with predominant respiratory symptoms. However, emerging evidence points to neurological disease manifestations, with an increasing number of
patients presenting with confirmed acute ischemic stroke
(AIS) (1,2). The underlying pathophysiology of vascular
thrombosis and subsequent AIS has been attributed to
cytokine storm, a severe immune reaction leading to an
increased inflammatory response and hypercoagulable
state (3). AIS develops in approximately 5% of hospitalized COVID-19 patients, with a mortality rate of around
39% (4). Most ischemic strokes occur in older patients
with traditional stroke risk factors and a 3-fold elevation
in the initial D-dimer level (5). Here, the author would
like to propose a modified emergency department (ED)
stroke code for the evaluation of patients with confirmed
or suspected COVID-19. A stroke code used in COVID-19
patients with a time-sensitive condition such as AIS needs
to ensure not only a rapid patient management, but also
stroke team safety and the optimal and safe use of scan
rooms and angio-suites
Keywords
Hrčak ID:
277998
URI
Publication date:
23.10.2020.
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