Society of NeuroInterventional Surgery recommendations for the care of emergent neurointerventional patients in the setting of COVID-19

Abstract

Patients with acute ischemic stroke (AIS) are a high-risk patient cohort. Li et al performed an analysis of six studies encompassing 1527 patients with COVID-19 and showed that patients with cardio/cerebrovascular disease comprised 16.4% of the cohort, but that the incidence was approximately threefold higher among patients with severe COVID-19 requiring intensive care (ICU) admission.3 Thus, patients with a history of AIS and/or its risk factors are particularly at risk for the severe form of COVID-19. Additionally, there is early evidence that SARS-CoV-2 can cause neurologic signs, and that it has been reported in the brains of both patients and animal models.4 Of patients with SARS-CoV-2 respiratory distress, 36.4% had neurologic symptoms with 4.5% of severe patients suffering ischemic stroke.5 In this setting, neurointerventionalists should expect to be involved in the care of COVID-19-positive patients, as well as those whose status is unknown and those at risk of a severe form of the disease.