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

Abootalebi S 1 , Aertker BM 2 , Andalibi MS 3 , Asdaghi N 4 , Aykac O 5 , Azarpazhooh MR 6 Show all authors , Bahit MC 7 , Barlinn K 8 , Basri H 9 , Shahripour RB 10 , Bersano A 11 , Biller J 12 , Borhani-Haghighi A 13 , Brown RD 14 , Campbell BC 15 , Cruz-Flores S 16 , De Silva DA 17 , Di Napoli M 18 , Divani AA 19 , Edgell RC 20 , Fifi JT 21 , Ghoreishi A 22 , Hirano T 23 , Hong KS 24 , Hsu CY 25 , Huang JF 26 , Inoue M 27 , Jagolino AL 28 , Kapral M 29 , Kee HF 30 , Keser Z 31 , Khatri R 32 , Koga M 33 , Krupinski J 34 , Liebeskind DS 35 , Liu L 36 , Ma H 37 , Maud A 38 , McCullough LD 39 , Meyer DM 40 , Mifsud V 41 , Morovatdar N 42 , Nilanont Y 43 , Oxley TJ 44 , Özdemir AÖ 5 , Pandian J 45 , Pantoni L 46 , Papamitsakis NIH 47 , Parry-Jones A 48 , Phan T 49 , Rodriguez G 38 , Romano JG 50 , Sabaa-Ayoun Z 51 , Saber H 52 , Sasannezhad P 53 , Saver JL 54 , Scharf E 55 , Shuaib A 56 , Silver B 57 , Singhal S 37 , Smith CJ 58 , Stranges S 59 , Sylaja PN 60 , Torbey M 61 , Toyoda K 62 , Tsivgoulis G 63 , Wasay M 64 , Yassi N 65 , Yoshimoto T 66 , Zamani B 67 , Zand R 68

Affiliations 

  • 1 Dr. Everett Chalmers Regional Hospital, Dalhousie University, New Brunswick, Canada. Electronic address: dr.shahram.abootalebi@horizonnb.ca
  • 2 Department of Neurology, UTHealth McGovern Medical School, The University of Texas at Houston, Houston, Texas, USA. Electronic address: benjamin.m.aertker@uth.tmc.edu
  • 3 International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: mssha96@gmail.com
  • 4 Department of Neurology, University of Miami, Miami, Florida, USA. Electronic address: nasdaghi@med.miami.edu
  • 5 Department of Neurology and Neurocritical Care, Eskisehir Osmangazi University, Eskişehir, Turkey
  • 6 Stroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada; Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: reza.azarpazhooh@lhsc.on.ca
  • 7 Chief of Cardiology, INECO Neurociencias, Rosario, Argentina
  • 8 Department of Neurology, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany. Electronic address: Kristian.Barlinn@ukdd.de
  • 9 Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia. Electronic address: hamidon@upm.edu.my
  • 10 University of Tennessee, Comprehensive Stroke center, Memphis, Tennessee, USA. Electronic address: rbavarsa@uthsc.edu
  • 11 Fondazione Istituto Neurologico 'Carlo Besta', Milan, Italy. Electronic address: anna.bersano@istituto-besta.it
  • 12 Department of Neurology, Loyola University Health System, Stritch School of Medicine, Chicago, USA. Electronic address: JBILLER@lumc.edu
  • 13 Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • 14 Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: brown@mayo.edu
  • 15 Department of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia. Electronic address: bruce.campbell@mh.org.au
  • 16 Neurology Department, Texas Tech Health University, El Paso, Texas, USA. Electronic address: salvador.cruz-flores@ttuhsc.edu
  • 17 National Neuroscience Institute, Singapore General Hospital campus, Singapore. Electronic address: deidre.desilva@singhealth.com.sg
  • 18 Department of Neurology and Stroke Unit, San Camillo de' Lellis General District Hospital, Rieti, Italy; Neurological Section, Neuro-epidemiology Unit, SMDN-Centre for Cardiovascular Medicine and Cerebrovascular Disease Prevention, Sulmona, L'Aquila, Italy. Electronic address: mariodinapoli@katamail.com
  • 19 Department of Neurology, School of Medicine, University of New Mexico, Albuquerque, New Mexico, USA
  • 20 Department of Neurology, Souers Stroke Institute, Saint Louis University, USA
  • 21 Departments of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA. Electronic address: Johanna.fifi@mountsinai.org
  • 22 Department of Neurology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
  • 23 Department of Stroke and Cerebrovascular Medicine, Kyorin University, Japan. Electronic address: terry@ks.kyorin-u.ac.jp
  • 24 Department of Neurology, Inje University, Ilsan Paik Hospital, Goyang, Republic of Korea
  • 25 Graduate Institute of Clinical Medical Science, China Medical University, Taipei, Taichung. Electronic address: hsuc@mail.cmu.edu.tw
  • 26 Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA. Electronic address: huang.josephine@mayo.edu
  • 27 Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. Electronic address: gakinoue@ncvc.go.jp
  • 28 Department of Neurology, UTHealth McGovern Medical School, The University of Texas at Houston, Houston, Texas, USA. Electronic address: amanda.l.jagolino@uth.tmc.edu
  • 29 Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada; Institute for Clinical Evaluative Sciences, Toronto, Canada. Electronic address: Moira.Kapral@uhn.ca
  • 30 Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
  • 31 Department of Neurology, UTHealth McGovern Medical School, The University of Texas at Houston, Houston, Texas, USA. Electronic address: Zafer.Keser@uth.tmc.edu
  • 32 Neurology Department, Texas Tech Health University, El Paso, Texas, USA. Electronic address: rakesh.khatri@ttuhsc.edu
  • 33 Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. Electronic address: koga@ncvc.go.jp
  • 34 Department of Neurology, Hospital Universitari MutuaTerrassa, Terrassa (Barcelona), Spain; Department of Life Sciences, CBS, Manchester Metropolitan University, Manchester, UK. Electronic address: jkrupinski@mutuaterrassa.es
  • 35 Department of Neurology, Geffen School of Medicine, UCLA, USA. Electronic address: dliebeskind@mednet.ucla.edu
  • 36 Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Beijing, China
  • 37 Department of Neurology, Monash Health and Department of Medicine, School of Clinical Sciences Monash University, Australia
  • 38 Neurology Department, Texas Tech Health University, El Paso, Texas, USA
  • 39 Department of Neurology, UTHealth McGovern Medical School, The University of Texas at Houston, Houston, Texas, USA. Electronic address: Louise.D.McCullough@uth.tmc.edu
  • 40 Department of Neurosciences, UCSD, USA. Electronic address: dmmeyer@health.ucsd.edu
  • 41 Neurologic Institute, Cleveland Clinic Abu Dhabi, UAE. Electronic address: MifsudV@clevelandclinicabudhabi.ae
  • 42 Clinical Research Development Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: MorovatdarN@mums.ac.ir
  • 43 Siriraj Stroke Center, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • 44 Department of Neurosurgery, Mount Sinai Hospital, New York, USA. Electronic address: tomoxl@mac.com
  • 45 Department of Neurology, Christian Medical College, Ludhiana, India
  • 46 Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy. Electronic address: leonardo.pantoni@unimi.it
  • 47 Department of Neurology, SUNY Downstate Medical Center, Brooklyn, New York, USA
  • 48 Manchester Centre for Clinical Neurosciences, Salford Royal National Health Service Foundation Trust, Manchester Academic Health Science Centre, Salford, UK. Electronic address: adrian.parry-jones@manchester.ac.uk
  • 49 Department of Neurology, Monash Health and Department of Medicine, School of Clinical Sciences Monash University, Australia. Electronic address: thanh.phan@monash.edu
  • 50 Department of Neurology, University of Miami, Miami, Florida, USA. Electronic address: JRomano@med.miami.edu
  • 51 Stroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada; Schulich School of Medicine and Dentistry, Western University, London, Ontario Canada. Electronic address: zsabaaay@uwo.ca
  • 52 David Geffen School of Medicine, Comprehensive Stroke Center, Department of Neurology, University of California, Los Angeles, USA. Electronic address: hsaber@bu.edu
  • 53 Department of Neurology, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: sasannejadp@mums.ac.ir
  • 54 Department of Neurology, Geffen School of Medicine, UCLA, USA. Electronic address: jsaver@mednet.ucla.edu
  • 55 Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: scharf.eugene@mayo.edu
  • 56 Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. Electronic address: shuaib@ualberta.ca
  • 57 Department of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts, USA. Electronic address: Brian.Silver@umassmemorial.org
  • 58 Division of Cardiovascular Sciences, Lydia Becker Institute of Immunology and Inflammation, University of Manchester, UK; Manchester Centre for Clinical Neurosciences, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Salford, UK. Electronic address: craig.smith-2@manchester.ac.uk
  • 59 Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg. Electronic address: saverio.stranges@uwo.ca
  • 60 Comprehensive Stroke Care Program, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Trivandrum 695 011, Kerala, India
  • 61 Department of Neurology, School of Medicine, University of New Mexico, Albuquerque, New Mexico, USA. Electronic address: mtorbey@salud.unm.edu
  • 62 Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. Electronic address: toyoda@ncvc.go.jp
  • 63 Second Department of Neurology, Attikon University Hospital, National & Kapodistrian University of Athens, Athens, Greece
  • 64 Aga Khan University, Karachi, Pakistan. Electronic address: mohammad.wasay@aku.edu
  • 65 Department of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital, University of Melbourne; Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia. Electronic address: nawaf.yassi@unimelb.edu.au
  • 66 Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. Electronic address: yoshimototakeshi1982@ncvc.go.jp
  • 67 Neurology department of Iran University of Medical Sciences, Tehran, Iran
  • 68 Neurology Department, Neuroscience Institute, Geisinger Health System, Danville, Pennsylvania, USA
J Stroke Cerebrovasc Dis, 2020 Sep;29(9):104938.
PMID: 32807412 DOI: 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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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