Time Is Brain: A Call to Action to Support Stroke Centers in Low- and Middle-Income Countries during the COVID-19 Pandemic

Type Journal Article Author Afshin Borhani-Haghighi Author Reza Bavarsad Shahripour Author Mahmoud Reza Azarpazhooh URL https://www.karger.com/Article/FullText/508608 Volume 83 Issue 3 Pages 310-311 Publication European Neurology | Clinical Neurology ISSN 0014-3022, 1421-9913 Date 15/07/2020 Extra Publisher: Karger Publishers PMID: 32668430 Journal Abbr ENE DOI 10.1159/000508608 Library Catalog www.karger.com Language english Abstract Dear Editor, COVID-19 infections may affect other noncommunicable diseases, such as stroke, both directly and indirectly. Stroke may increase the probability of severe infection and mortality in COVID-19 infections. COVID-19 may lead to cardiac injury, arrhythmia, myocarditis, coagulopathy, and consequently stroke [1]. As an example, in Iran, neurologists identified some stroke cases among COVID-19 cases. Given the health infrastructure differences, economic differences, and previous differences in the burden of stroke between low- and middle-income (LMICs) versus high-income countries [2, 3], LMICs, in particular, may face a considerable strain with a possible negative impact on the healthcare delivery system. While we are globally fighting COVID-19, we need to implement feasible approaches to prevent or at least minimize any breakdown in the previous preventive and treatment approaches. We here recommend some suggestions and a call to action in LMICs. Healthcare professionals are at a higher risk of COVID-19 than the normal population [4]. Given the previous staff shortages in healthcare in many LMICs, providing personal protection equipment should be prioritized. We encourage international organizations, such as the World Federation of Neurology (WFN) and World Stroke Organization (WSO), to help provide personal protection equipment for LMICs. Social isolation does not mean lack of social interactions. We recommend health policymakers to authorize telemedicine technology in LMICs. Many important aspects of acute stroke management, from EMS dispatch to the selection of eligible cases for intravenous thrombolysis or endovascular therapy, can be performed via Telestroke Short Title Time Is Brain