Call to Action: SARS-CoV-2 and CerebrovAscular DisordErs (CASCADE)

Authors

Shahram Abootalebi, Dalhousie University
Benjamin M. Aertker, UTHealth McGovern Medical School
Mohammad Sobhan Andalibi, Mashhad University of Medical Sciences
Negar Asdaghi, University of Miami
Ozlem Aykac, Eskişehir Osmangazi Üniversitesi
M. Reza Azarpazhooh, Robarts Research Institute
M. Cecilia Bahit, Chief of Cardiology
Kristian Barlinn, Universitätsklinikum Carl Gustav Carus Dresden
Hamidon Basri, Universiti Putra Malaysia
Reza Bavarsad Shahripour, University of Tennessee Health Science Center
Anna Bersano, Foundation IRCCS Neurological Institute "C. Besta"
Jose Biller, Loyola University Health System
Afshin Borhani-Haghighi, Clinical Neurology Research Center
Robert D. Brown, Mayo Clinic
Bruce CV Campbell, University of Melbourne
Salvador Cruz-Flores, Texas Tech Health University Health Sciences Center
Deidre Anne De Silva, Singapore General Hospital
Mario Di Napoli, San Camillo de' Lellis District General Hospital
Afshin A. Divani, UNM School of Medicine
Randall C. Edgell, St. Louis University
Johanna T. Fifi, Icahn School of Medicine at Mount Sinai
Abdoreza Ghoreishi, School of Medicine, Zanjan University of Medical Sciences (ZUMS)
Teruyuki Hirano, Kyorin University
Keun Sik Hong, Inje University
Chung Y. Hsu, China Medical University Taichung
Josephine F. Huang, Mayo Clinic in Jacksonville, Florida
Manabu Inoue, Kokuritsu Junkankibyo Senta
Amanda L. Jagolino, UTHealth McGovern Medical School
Moira Kapral, Institute of Health Policy, Management and Evaluation
Hoo Fan Kee, Universiti Putra Malaysia
Zafer Keser, UTHealth McGovern Medical School
Rakesh Khatri, Texas Tech Health University Health Sciences Center

Document Type

Article

Publication Date

9-1-2020

Journal

Journal of Stroke and Cerebrovascular Diseases

Volume

29

Issue

9

URL with Digital Object Identifier

10.1016/j.jstrokecerebrovasdis.2020.104938

Abstract

Background and purpose: The novel severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), now named coronavirus disease 2019 (COVID-19), may change the risk of stroke through an enhanced systemic inflammatory response, hypercoagulable state, and endothelial damage in the cerebrovascular system. Moreover, due to the current pandemic, some countries have prioritized health resources towards COVID-19 management, making it more challenging to appropriately care for other potentially disabling and fatal diseases such as stroke. The aim of this study is to identify and describe changes in stroke epidemiological trends before, during, and after the COVID-19 pandemic. Methods: This is an international, multicenter, hospital-based study on stroke incidence and outcomes during the COVID-19 pandemic. We will describe patterns in stroke management, stroke hospitalization rate, and stroke severity, subtype (ischemic/hemorrhagic), and outcomes (including in-hospital mortality) in 2020 during COVID-19 pandemic, comparing them with the corresponding data from 2018 and 2019, and subsequently 2021. We will also use an interrupted time series (ITS) analysis to assess the change in stroke hospitalization rates before, during, and after COVID-19, in each participating center. Conclusion: The proposed study will potentially enable us to better understand the changes in stroke care protocols, differential hospitalization rate, and severity of stroke, as it pertains to the COVID-19 pandemic. Ultimately, this will help guide clinical-based policies surrounding COVID-19 and other similar global pandemics to ensure that management of cerebrovascular comorbidity is appropriately prioritized during the global crisis. It will also guide public health guidelines for at-risk populations to reduce risks of complications from such comorbidities.