The impact of COVID-19 on patients with stroke: an integrative review

Purpose - This review aims to evaluate the evidence of the impact of COVID-19 on patients with stroke. Design/methodology/approach - The author carried out a review following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for a review article. PubMed, the Web of Science and CINAHL Plus Full Text were searched from January 2019 to October 2020. Twentythree studies were included in the final review, incorporating a total of 9,819 stroke patients. Findings - The most commonly reported effects of COVID-19 on patients with stroke were delayed stroke treatment (n = 14 studies), thrombotic, blood and immune system complications (n = 8), increased risk of stroke severity and disability (n = 6), increased mortality (n = 8), elevated D-dimer levels (n = 4), comorbidity and acute respiratory distress syndrome (ARDS) (n = 6) and prolonged hospitalization (n = 4). Originality/value - COVID-19 has affected patients with stroke in various ways, either directly or indirectly, prior to admission or in hospital. The findings should help guide further investigation of the long-term impact of COVID-19 on patients with stroke and help to establish proper guidelines for the provision of efficient treatment for affected patients.