TY  - JOUR
A1  - Schmidbauer, Moritz L.
A1  - Ferse, Caroline
A1  - Salih, Farid
A1  - Klingner, Carsten
A1  - Musleh, Rita
A1  - Kunst, Stefan
A1  - Wittstock, Matthias
A1  - Neumann, Bernhard
A1  - Schebesch, Karl-Michael
A1  - Bösel, Julian
A1  - Godau, Jana
A1  - Lochner, Piergiorgio
A1  - Adam, Elisabeth H.
A1  - Jahnke, Kolja
A1  - Knier, Benjamin
A1  - Schirotzek, Ingo
A1  - Müllges, Wolfgang
A1  - Notz, Quirin
A1  - Dengl, Markus
A1  - Güldner, Andreas
A1  - Onur, Oezguer A.
A1  - Garcia Borrega, Jorge
A1  - Dimitriadis, Konstantinos
A1  - Günther, Albrecht
T1  - COVID-19 and intracranial hemorrhage: a multicenter case series, systematic review and pooled analysis
JF  - Journal of Clinical Medicine
N2  - Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) profoundly impacts hemostasis and microvasculature. In the light of the dilemma between thromboembolic and hemorrhagic complications, in the present paper, we systematically investigate the prevalence, mortality, radiological subtypes, and clinical characteristics of intracranial hemorrhage (ICH) in coronavirus disease (COVID-19) patients. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we performed a systematic review of the literature by screening the PubMed database and included patients diagnosed with COVID-19 and concomitant ICH. We performed a pooled analysis, including a prospectively collected cohort of critically ill COVID-19 patients with ICH, as part of the PANDEMIC registry (Pooled Analysis of Neurologic Disorders Manifesting in Intensive Care of COVID-19). Results: Our literature review revealed a total of 217 citations. After the selection process, 79 studies and a total of 477 patients were included. The median age was 58.8 years. A total of 23.3% of patients experienced the critical stage of COVID-19, 62.7% of patients were on anticoagulation and 27.5% of the patients received ECMO. The prevalence of ICH was at 0.85% and the mortality at 52.18%, respectively. Conclusion: ICH in COVID-19 patients is rare, but it has a very poor prognosis. Different subtypes of ICH seen in COVID-19, support the assumption of heterogeneous and multifaceted pathomechanisms contributing to ICH in COVID-19. Further clinical and pathophysiological investigations are warranted to resolve the conflict between thromboembolic and hemorrhagic complications in the future.
KW  - COVID-19
KW  - intracranial hemorrhage
KW  - prognosis
KW  - anticoagulation
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-255236
SN  - 2077-0383
VL  - 11
IS  - 3
ER  - 
TY  - JOUR
A1  - Vollmuth, Christoph
A1  - Muljukov, Olga
A1  - Abu-Mugheisib, Mazen
A1  - Angermeier, Anselm
A1  - Barlinn, Jessica
A1  - Busetto, Loraine
A1  - Grau, Armin J.
A1  - Günther, Albrecht
A1  - Gumbinger, Christoph
A1  - Hubert, Nikolai
A1  - Hüttemann, Katrin
A1  - Klingner, Carsten
A1  - Naumann, Markus
A1  - Palm, Frederick
A1  - Remi, Jan
A1  - Rücker, Viktoria
A1  - Schessl, Joachim
A1  - Schlachetzki, Felix
A1  - Schuppner, Ramona
A1  - Schwab, Stefan
A1  - Schwartz, Andreas
A1  - Trommer, Adrian
A1  - Urbanek, Christian
A1  - Volbers, Bastian
A1  - Weber, Joachim
A1  - Wojciechowski, Claudia
A1  - Worthmann, Hans
A1  - Zickler, Philipp
A1  - Heuschmann, Peter U.
A1  - Haeusler, Karl Georg
A1  - Hubert, Gordian Jan
T1  - Impact of the coronavirus disease 2019 pandemic on stroke teleconsultations in Germany in the first half of 2020
JF  - European Journal of Neurology
N2  - Background and purpose
The effects of the coronavirus disease 2019 (COVID-19) pandemic on telemedical care have not been described on a national level. Thus, we investigated the medical stroke treatment situation before, during, and after the first lockdown in Germany.

Methods
In this nationwide, multicenter study, data from 14 telemedical networks including 31 network centers and 155 spoke hospitals covering large parts of Germany were analyzed regarding patients' characteristics, stroke type/severity, and acute stroke treatment. A survey focusing on potential shortcomings of in-hospital and (telemedical) stroke care during the pandemic was conducted.

Results
Between January 2018 and June 2020, 67,033 telemedical consultations and 38,895 telemedical stroke consultations were conducted. A significant decline of telemedical (p < 0.001) and telemedical stroke consultations (p < 0.001) during the lockdown in March/April 2020 and a reciprocal increase after relaxation of COVID-19 measures in May/June 2020 were observed. Compared to 2018–2019, neither stroke patients' age (p = 0.38), gender (p = 0.44), nor severity of ischemic stroke (p = 0.32) differed in March/April 2020. Whereas the proportion of ischemic stroke patients for whom endovascular treatment (14.3% vs. 14.6%; p = 0.85) was recommended remained stable, there was a nonsignificant trend toward a lower proportion of recommendation of intravenous thrombolysis during the lockdown (19.0% vs. 22.1%; p = 0.052). Despite the majority of participating network centers treating patients with COVID-19, there were no relevant shortcomings reported regarding in-hospital stroke treatment or telemedical stroke care.

Conclusions
Telemedical stroke care in Germany was able to provide full service despite the COVID-19 pandemic, but telemedical consultations declined abruptly during the lockdown period and normalized after relaxation of COVID-19 measures in Germany.
KW  - COVID-19
KW  - SARS-CoV- 2
KW  - stroke
KW  - telemedicine
KW  - survey
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-259396
VL  - 28
IS  - 10
ER  -