COVID-19 (coronavirus): resources for the stroke care team
The new coronavirus disease (COVID-19) is caused by a strain of coronavirus (SARS-CoV-2) first encountered in November 2019, and not previously identified in humans. The virus can cause pneumonia-like symptoms, including fever, cough, and shortness of breath. On March 11 2020, the World Health Organization (WHO) announced the current COVID-19 outbreak as a pandemic.
Guidance for the stroke care teams:
- Stroke Association: Information and advice on coronavirus (COVID-19) for people affected by stroke
- Chest, Heart and Stroke Scotland (CHSS): Coronavirus information and support, including general advice, a resources hub, information and support from CHSS
- American Heart Association (AHA)/ American Stroke Association (ASA): some helpful resources for health systems, clinics, care providers, patients and the public; COVID-19 Content: An AHA Compendium
- World Stroke Organization (WSO): Stroke Care and the COVID19 Pandemic: updates and perspectives on stroke care and the COVID19 pandemic
- European Stroke Organisation (ESO): Stroke care during the COVID-19 pandemic and Archive for COVID-19
- Stroke Alliance for Europe (SAFE): COVID-19 resources pages from SAFE member countries
Cochrane evidence and COVID-19:
- Cochrane resources and news: This page highlights content relating to the coronavirus (COVID-19) pandemic and the various related activities that Cochrane is undertaking in response. Cochrane has an extensive collection of resources related to COVID-19 and these are available: here.
- Cochrane COVID Rapid Reviews. Cochrane is engaging with a range of stakeholders to build a bank of important questions emerging from the COVID-19 pandemic, including the World Health Organization (WHO), the Australian National Health and Medical Research Council (NHMRC), the UK National Institute for Health Research (NIHR) and the Brazilian Ministry of Health. The first 60 questions underwent a very early prioritisation process to allow work to begin immediately on urgent reviews. The remaining questions will undergo a rapid prioritisation process with stakeholders. The list of suggested topics can be found here.
- Cochrane’s COVID-19 Study Register. Cochrane has launched a COVID-19 trial register to support rapid evidence synthesis, find it here.
Search strategies for stroke and COVID-19:
Staying up-to-date with the rapidly-growing amount of literature on the COVID-19 outbreak is exceptionally challenging as hundreds of new papers are published every day on biomedical literature databases and preprint servers. To help you keep pace with literature pertaining to stroke/cerebrovascular healthcare and the COVID-19 outbreak, the Cochrane Stroke Group’s Information Specialist has developed a collection of search strategies on the Cochrane Library, the MEDLINE Ovid platform, PubMed, ClinicalTrials.gov, and Google Scholar. These searches have not been limited by language, region, or study design.
Searches have been written for the following resources:
- The Cochrane Library (https://www.cochranelibrary.com/)
- PubMed (https://pubmed.ncbi.nlm.nih.gov/)
- MEDLINE (Ovid)
- Google Scholar (https://scholar.google.com/)
- US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov (https://www.clinicaltrials.gov)
For more information on Cochrane's response to COVID-19 see Coronavirus (COVID-19): Cochrane resources and news.
World Health Organization Coronavirus (COVID-19) pandemic (https://www.who.int/emergencies/diseases/novel-coronavirus-2019)
The Cochrane Database of Systematic Reviews (CDSR) and Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library:
PubMed COVID-19 and stroke: The COVID-19 strategy used in this search has been adapted from the PubMed search strategy designed by Farhad Shokraneh (Shokraneh 2020):
US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov (www.clinicaltrials.gov) for ongoing clinical trials relevant to COVID-19 and stroke healthcare:
Search on Google Scholar on COVID-19 and stroke healthcare:
MEDLINE Ovid (1946 to present) on COVID-19 and stroke healthcare:
The following search can be run in MEDLINE Ovid (last updated 05 May 2020).
This search was constructed using the MEDLINE Ovid platform using a combination of Medical Subject Headings (MeSH) and uncontrolled vocabulary and is designed to retrieve all potential references pertaining to stroke healthcare (including transient ischaemic attack, cerebral small vessel disease, and subarachnoid haemorrhage) and coronavirus (COVID-19) in MEDLINE Ovid. Lines 1-10 (stroke and cerebrovascular disorders) were developed by Joshua Cheyne (firstname.lastname@example.org) in May 2020. Lines 11-20 (COVID-19) have been adapted from the Ovid Expert Searches focused on COVID-19.
This search should be run on Ovid MEDLINE(R) All 1946 to present or Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Daily and Versions(R) 1946 to present).
1. cerebrovascular disorders/ or exp basal ganglia cerebrovascular disease/ or brain ischemia/ or exp brain infarction/ or ischemic attack, transient/ or vertebrobasilar insufficiency/ or exp carotid artery diseases/ or cerebral small vessel diseases/ or cerebral amyloid angiopathy, familial/ or stroke, lacunar/ or cerebrovascular trauma/ or vertebral artery dissection/ or intracranial arterial diseases/ or cerebral arterial diseases/ or cerebral amyloid angiopathy/ or infarction, anterior cerebral artery/ or infarction, middle cerebral artery/ or infarction, posterior cerebral artery/ or moyamoya disease/ or intracranial aneurysm/ or intracranial arteriosclerosis/ or exp intracranial arteriovenous malformations/ or exp "intracranial embolism and thrombosis"/ or intracranial hemorrhages/ or exp cerebral hemorrhage/ or intracranial hemorrhage, hypertensive/ or exp intracranial hemorrhage, traumatic/ or exp subarachnoid hemorrhage/ or stroke/ or vasospasm, intracranial/
2. stroke rehabilitation/
3. (stroke or poststroke or post-stroke or cerebrovasc$ or (cerebr$ adj3 vasc$) or CVA$ or apoplectic or apoplex$ or (transient adj3 isch?emic adj3 attack) or tia$ or SAH or AVM or (cerebral small vessel adj3 disease)).tw.
4. ((cerebr$ or cerebell$ or arteriovenous or vertebrobasil$ or interhemispheric or hemispher$ or intracran$ or intracerebral or infratentorial or supratentorial or MCA$ or ((anterior or posterior) adj3 circulat$) or lenticulostriate or ((basilar or brachial or vertebr$) adj3 arter$)) adj3 (disease or damage$ or disorder$ or disturbance or dissection or syndrome or arrest or accident or lesion or vasculopathy or insult or attack or injury or insufficiency or malformation or obstruct$ or anomal$)).tw.
5. (((cerebr$ or cerebell$ or vertebrobasil$ or interhemispheric or hemispher$ or intracran$ or corpus callosum or intracerebral or intracortical or intraventricular or periventricular or posterior fossa or infratentorial or supratentorial or MCA$ or ((anterior or posterior) adj3 circulation) or basal ganglia or ((basilar or brachial or vertebr$) adj3 arter$) or space-occupying or brain ventricle$ or subarachnoid$ or arachnoid$) adj3 (h?emorrhage or h?ematoma or bleed$ or encephalorrhagia or hematencephal$).tw.
6. ((cerebr$ or cerebell$ or arteriovenous or vertebrobasil$ or interhemispheric or hemispher$ or intracran$ or corpus callosum or intracerebral or intracortical or intraventricular or periventricular or posterior fossa or infratentorial or supratentorial or MCA$ or ((anterior or posterior) adj3 circulation) or basal ganglia or ((basilar or brachial or vertebr$) adj3 arter$) or space-occupying or brain ventricle$ or lacunar or cortical or ocular) adj3 (isch?emi$ or infarct$ or thrombo$ or emboli$ or occlus$ or hypoxi$ or vasospasm or obstruct$ or vasoconstrict$)).tw.
7. ((carotid or cerebr$ or cerebell$ or intracranial or basilar or brachial or vertebr$) adj3 (aneurysm or malformation$ or dysplasia or disease or bruit or injur$ or obstruct$ or occlusion or constriction or presclerosis or scleros$ or stenos$ or atherosclero$ or arteriosclero$ or plaque$ or thrombo$ or embol$ or arteriopathy)).tw.
8. hemianopsia/ or hemiplegia/ or paresis/ or exp gait disorders, neurologic/
9. (hemipleg$ or hemipar$ or paresis or paretic or hemineglect or ((unilateral or visual or hemispatial or attentional or spatial) adj5 neglect)).tw.
11. exp Coronavirus/
12. exp Coronavirus Infections/
13. (coronavirus$ or corona virus$ or OC43 or NL63 or 229E or HKU1 or HCoV$ or ncov$ or covid$ or sars-cov$ or sarscov$ or Sars-coronavirus$ or Severe Acute Respiratory Syndrome Coronavirus$).mp.
14. 11 or 12 or 13
15. (20191$ or 202$).dp. or 20190101:20301231.(ep).
16. 14 and 15
17. ((pneumonia or covid$ or coronavirus$ or corona virus$ or ncov$ or 2019-ncov or sars$).tw. or exp pneumonia/) and Wuhan.mp.
18. (2019-ncov or ncov19 or ncov-19 or 2019-novel CoV or sars-cov2 or sars-cov-2 or sarscov2 or sarscov-2 or Sars-coronavirus2 or Sars-coronavirus-2 or SARS-like coronavirus$ or coronavirus-19 or covid19 or covid-19 or covid 2019 or ((novel or new or nouveau) adj2 (CoV or nCoV or covid or coronavirus$ or corona virus or Pandemi$2)) or ((covid or covid19 or covid-19) and (outbreak or crisis or pandemic$2)) or (coronavirus$ and pneumonia)).mp.
19. COVID-19.rx,px,ox. or severe acute respiratory syndrome coronavirus 2.os.
21. 10 and 20
General guidance on COVID-19 (this list of resources was originally compiled by the Cochrane Oral Health Group and has been reproduced here with their permission):
- The World Health Organization (WHO) advice on infection control for healthcare workers can be found here, and there are more coronavirus resources from WHO here. They have also published guidance on maintaining essential health services during the outbreak.
- The European Centre for Disease Prevention and Control has issued guidance on infection prevention and control for caring for patients with COVID-19 in healthcare settings.
- Evidence Aid's Coronavirus resources include evidence on healthcare workers' protection and prevention management.
- Healthare Improvement Scotland (HIS) and the Scottish Intercollegiate Guidelines Network (SIGN) have highlighted a number of reliable resources and guidance on COVID-19, including guidelines, evidence reviews, and information for NHS staff, healthcare professionals, and the public.
- Public Health England (PHE) resources relating to Coronavirus can be found here, these include information and advice on aerosol-generating procedures (AGPs). Find some advice on personal protective equipment here.
- The National Institute for Health and Care Excellence (NICE) are publishing a series of rapid guidelines, on the management of coronavirus, find out more here.
- The Centre for Evidence-Based Medicine (CEBM) in Oxford has a series of rapid reviews underway, check back often for updates.
Acknowledgements: Thank you Marshall Dozier from the University of Edinburgh, Farhad Shokraneh of Cochrane Schizophrenia, Anne Littlewood of Cochrane Oral Health, and Doug Salzwedel of Cochrane Hypertension.
1.Shokraneh F. Keeping up with studies on COVID-19: Systematic Search Strategies and Resources. British Medical Journal 2020; 368: m1199 (doi: https://doi.org/10.1136/bmj.m1199).