Mechanical thrombectomy (MT) for acute ischemic stroke (AIS) in COVID-19 pandemic: a systematic review

Abstract

IntroductionCoronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Initially, COVID-19 is a disease that attacks the respiratory tract, but now the clinical manifestations of COVID-19 are various, including acute ischemic stroke (AIS). Emergency surgeries such as mechanical thrombectomy (MT) for AIS must be performed without any delay even during the COVID-19 pandemic, to reduce morbidity and mortality. Besides the focus on patient’s health, the safety of healthcare workers must also be considered. The aim of the study was to evaluate and summarize the scientific literature systematically to explore MT for AIS in the COVID-19 pandemic.Data synthesisThe independent reviewers searched the literature through 12 electronic databases, searching for articles fulfilling inclusion and exclusion criteria. The data from all included studies were presented in a summary table featuring key points of each study. The authors independently assessed the risk of bias of 15 included articles.ConclusionAlthough MT procedure has been prolonged during the pandemic, clinical outcomes and procedure-related serious adverse events have remained unchanged during the COVID-19 pandemic. The screening process and the implementation of the PCS algorithm must be performed to reduce the spread of COVID-19 infection without threatening patient safety and clinical outcomes. The standard precaution of infection and the health assurance of healthcare workers and their families (including mental health) are also important factors that must be given special attention and consideration in the COVID-19 pandemic.