Navigating stroke care during the COVID-19 pandemic: a scoping review

The COVID-19 pandemic has profoundly affected the management of complex health conditions, including stroke care. This study investigates the impact of the pandemic on stroke care by analyzing changes in healthcare utilization, the long-term effects on post-stroke recovery, and the overall quality of life of stroke survivors. A scoping review was conducted using the Joanna Briggs Institute Methodology for Scoping Reviews. We searched electronic databases (APA PsycInfo, Embase, Medline, and CINAHL) for English-language primary research articles, including original research articles and case reports published between December 2019 and September 2024. The review focused on individuals who experienced a stroke during the COVID-19 pandemic. Data extraction identified study characteristics and significant findings, facilitating a qualitative and narrative synthesis of the gathered evidence. Out of 1405 studies screened, 107 met the inclusion criteria. Seven sub-themes were identified from these articles, describing systemic transformations in stroke care during the COVID-19 pandemic [1]: patient behavior and awareness (e.g. fear of contracting COVID-19 in hospital) [2]; telemedicine and remote care (e.g. decreased in-person consultations) [3]; delays in treatment (e.g. reduced utilization of critical interventions) [4]; impact on healthcare resources (e.g. strain on resources led to fragmented care) [5]; quality of care (e.g. declines in care metrics and outcomes) [6]; changes in stroke severity (i.e. greater stroke severity at presentation); and [7] reduction in stroke admissions (due to patient reluctance and changes in healthcare practices). The COVID-19 pandemic significantly impacted stroke care globally, leading to increased patient reluctance to seek medical attention, delays in treatment, and a rise in stroke severity. The shift to telemedicine and the strain on healthcare resources further disrupted stroke care, resulting in declines in quality metrics and reduced stroke admissions. This review underscores the need for adaptable stroke care systems, improved telemedicine access, and enhanced patient education to address pandemic-related challenges and inform future emergency preparedness. Not applicable.