Acute Neurological Care in the COVID-19 Era: The Pandemic Health SystemREsiliencePROGRAM(REPROGRAM) Consortium Pathway
Acute Neurological Care in the COVID-19 Era: The Pandemic Health SystemREsiliencePROGRAM(REPROGRAM) Consortium Pathway
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DOI：
10.3389/fneur.2020.00579
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发表时间：
2020-05-29
影响因子：
3.4
通讯作者：
Jabbour, Pascal
中科院分区：
文献类型：
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作者：
Bhaskar, Sonu;Sharma, Divyansh;Jabbour, Pascal
考虑到2019冠状病毒病（COVID-19）对医护人员和患者的感染风险以及新出现的病毒具有神经侵入潜力的证据，在2019冠状病毒病（COVID-19）背景下，对急性神经系统疾病，特别是急性缺血性中风的管理非常重要。专家指南的变化进一步使临床医生在急性环境中的情况复杂化。有鉴于此，迫切需要进一步拟订建议，汇编目前众多准则中的这些变化。管理正在进行的急性神经系统护理和干预的卫生系统方案需要考虑一线卫生保健工作者和患者的安全和福祉。我们研究了现有的途径及其减少病毒暴露给医护人员和患者的效果，并综合了一种系统的方法来管理COVID-19情景下的急性神经系统疾病患者。本文介绍了一名接受血管内血栓切除术的COVID-19阳性卒中患者的早期经验，以强调在急性神经介入手术期间迫切需要足够的个人防护装备。
The management of acute neurological conditions, particularly acute ischemic stroke, in the context of Coronavirus disease 2019 (COVID-19), is of importance, considering the risk of infection to the healthcare workers and patients and emerging evidence of the neuroinvasive potential of the virus. There are variations in expert guidelines further complicating the picture for clinicians in acute settings. In this light, there is a compelling need for further formulation of recommendations that compile these variations seen in the numerous guidelines present. Health system protocols for managing ongoing acute neurological care and intervention need consideration of safety and well-being of the frontline healthcare workers and the patients. We examine existing pathways and their efficacy to mitigate viral exposure to the healthcare workers and patients and synthesize a systemic approach to manage patients with acute neurological conditions in the COVID-19 scenario. Early experiences with a COVID-19 positive stroke patient treated with endovascular thrombectomy is presented to highlight the urgent need for adequate personal protective equipment (PPE) during acute neuro-interventional procedures.