行动呼吁：2019冠状病毒病与脑血管疾病（CASCADE）。
Call to Action: SARS-CoV-2 and CerebrovAscular DisordErs (CASCADE).
作者信息
Abootalebi Shahram, Aertker Benjamin M, Andalibi Mohammad Sobhan, Asdaghi Negar, Aykac Ozlem, Azarpazhooh M Reza, Bahit M Cecilia, Barlinn Kristian, Basri Hamidon, Shahripour Reza Bavarsad, Bersano Anna, Biller Jose, Borhani-Haghighi Afshin, Brown Robert D, Campbell Bruce Cv, Cruz-Flores Salvador, De Silva Deidre Anne, Di Napoli Mario, Divani Afshin A, Edgell Randall C, Fifi Johanna T, Ghoreishi Abdoreza, Hirano Teruyuki, Hong Keun-Sik, Hsu Chung Y, Huang Josephine F, Inoue Manabu, Jagolino Amanda L, Kapral Moira, Kee Hoo Fan, Keser Zafer, Khatri Rakesh, Koga Masatoshi, Krupinski Jerzy, Liebeskind David S, Liu Liping, Ma Henry, Maud Alberto, McCullough Louise D, Meyer Dawn Matherne, Mifsud Victoria, Morovatdar Negar, Nilanont Yongchai, Oxley Thomas J, Özdemir Atilla Özcan, Pandian Jeyaraj, Pantoni Leonardo, Papamitsakis Nikolaos I H, Parry-Jones Adrian, Phan Thanh, Rodriguez Gustavo, Romano Jose G, Sabaa-Ayoun Ziad, Saber Hamidreza, Sasannezhad Payam, Saver Jeffrey L, Scharf Eugene, Shuaib Ashfaq, Silver Brian, Singhal Shaloo, Smith Craig J, Stranges Saverio, Sylaja P N, Torbey Michel, Toyoda Kazunori, Tsivgoulis Georgios, Wasay Mohammad, Yassi Nawaf, Yoshimoto Takeshi, Zamani Babak, Zand Ramin
机构信息
Dr. Everett Chalmers Regional Hospital, Dalhousie University, New Brunswick, Canada.
Department of Neurology, UTHealth McGovern Medical School, The University of Texas at Houston, Houston, Texas, USA.
出版信息
J Stroke Cerebrovasc Dis. 2020 Sep;29(9):104938. doi: 10.1016/j.jstrokecerebrovasdis.2020.104938. Epub 2020 May 8.
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.
背景与目的
新型严重急性呼吸综合征冠状病毒2（SARS-CoV-2），现称为冠状病毒病2019（COVID-19），可能通过增强全身炎症反应、高凝状态和脑血管系统的内皮损伤来改变中风风险。此外，由于当前的大流行，一些国家已将卫生资源优先用于COVID-19管理，这使得妥善护理其他潜在致残和致命疾病（如中风）更具挑战性。本研究的目的是识别和描述COVID-19大流行之前、期间和之后中风流行病学趋势的变化。
方法
这是一项关于COVID-19大流行期间中风发病率和结局的国际多中心医院研究。我们将描述2020年COVID-19大流行期间中风管理模式、中风住院率、中风严重程度、亚型（缺血性/出血性）和结局（包括住院死亡率），并将其与2018年和2019年以及随后的2021年的相应数据进行比较。我们还将使用中断时间序列（ITS）分析来评估每个参与中心在COVID-19之前、期间和之后中风住院率的变化。
结论
拟议的研究可能使我们能够更好地了解与COVID-19大流行相关的中风护理方案、差异住院率和中风严重程度的变化。最终，这将有助于指导围绕COVID-19和其他类似全球大流行的基于临床的政策，以确保在全球危机期间适当优先处理脑血管合并症。它还将指导针对高危人群的公共卫生指南，以降低此类合并症并发症的风险。
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