The COVID-19 outbreak has had a major impact across the whole of India, affecting all aspects of people’s daily lives and triggered psychological problems of anxiety and panic . During the peak period of the outbreak in February and March 2020, the implementation of national policies to avoid social gatherings and travel to high-risk areas resulted in hospitals reducing outpatient clinics and many services were restricted to urgent cases. Consequently, clinical research abruptly ceased, hospitals suspended ethics committee submissions and their review, and few in-person participant assessments were conducted. India is now emerging from this difficult period, but the shadow of COVID-19 continues, as we have encountered during initiation of the INTEnsive ambulance-delivered blood pressure Reduction in hyper-ACute stroke Trial.
As the effectiveness of reperfusion therapy in highly time-dependent, public health strategies encourage patients to urgently call an ambulance, so that they can present rapidly to hospital after the onset of symptoms suggestive of acute stroke, most popularly defined by the Face symmetry, Arm weakness, Speech slurring, and Time to call (FAST) tool. We wish to highlight how COVID-19 has jeopardized this approach by adversely influencing the behavior of patients with suspected stroke.
Although “time is brain” is critical for effective reperfusion therapy, COVID-19 has clearly impacted the behavior of patients in India, as inferred elsewhere ,with the likelihood that this will have flow-on adverse effects in reducing the potential for recovery from stroke and increasing the impact of subsequent disability on families and society. Although various clinical guidelines for the management of stroke during the COVID-19 pandemic have been released , additional efforts are needed to reassure the population and encourage people to seek rapid access to stroke services in order to receive essential interventions.
Informative