Acute stroke care during the COVID-19 pandemic. Ictus Madrid Program recommendations

Rodríguez-Pardo, J.; Fuentes, B.; Alonso de Leciñana, M.; Campollo, J.; Calleja Castaño, P.; Carneado Ruiz, J.; Egido Herrero, J.; García Leal, R.; Gil Núñez, A.; Gómez Cerezo, J. F.; Martín Martínez, A.; Masjuán Vallejo, J.; Palomino Aguado, B.; Riera López, N.; Simón de las Heras, R.; Vivancos Mora, J.; Díez Tejedor, E.

Abstract Background The COVID-19 pandemic has forced a reorganisation of healthcare systems and an exceptional saturation of their resources. In this context, it is vital to ensure acute stroke care and optimise the care processes of the stroke code to reduce the risk of contagion and rationalise the use of hospital resources. To do this, the Ictus Madrid Multidisciplinary Group proposes a series of recommendations. Methods Non-systematic bibliographic review of the available publications with the terms “stroke” and “COVID-19” or “coronavirus” or “SARS-CoV-2”, as well as other already known for the authors. We provide a document of recommendations as a result of the consensus of the Ictus Madrid Multidisciplinary Group and its Neurology Committee. Results Our recommendations are structured on five lines: (1) coordinate to guarantee the access to hospital care for stroke patients, (2) recognise potentially COVID-19 infected stroke patients, (3) organise to ensure the protection of healthcare professionals from COVID-19 infections, (4) neuroimaging and other procedures potentially associated to risks for COVID-19 infection should be reduced and secured to avoid contagion, and (5) at home as soon as possible and supported follow-up to optimise hospital occupancy. The procedure is shown summarised under the acronym CORONA (COordinate, Recognise, Organise, Neuroimaging, At home). Conclusions These recommendations can support the organisation of healthcare services for acute stroke care and the optimisation of their resources, guaranteeing the protection of healthcare professionals.