Browsing by Author "Hamidreza Saber"

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    Call to Action: SARS-CoV-2 and CerebrovAscular DisordErs (CASCADE)
    (2020-09-01) Shahram Abootalebi; Benjamin M. Aertker; Mohammad Sobhan Andalibi; Negar Asdaghi; Ozlem Aykac; M. Reza Azarpazhooh; M. Cecilia Bahit; Kristian Barlinn; Hamidon Basri; Reza Bavarsad Shahripour; Anna Bersano; Jose Biller; Afshin Borhani-Haghighi; Robert D. Brown; Bruce CV Campbell; Salvador Cruz-Flores; Deidre Anne De Silva; Mario Di Napoli; Afshin A. Divani; Randall C. Edgell; Johanna T. Fifi; Abdoreza Ghoreishi; Teruyuki Hirano; Keun Sik Hong; Chung Y. Hsu; Josephine F. Huang; Manabu Inoue; Amanda L. Jagolino; Moira Kapral; Hoo Fan Kee; Zafer Keser; Rakesh Khatri; Masatoshi Koga; Jerzy Krupinski; David S. Liebeskind; Liping Liu; Henry Ma; Alberto Maud; Louise D. McCullough; Dawn Matherne Meyer; Victoria Mifsud; Negar Morovatdar; Yongchai Nilanont; Thomas J. Oxley; Atilla Özcan Özdemir; Jeyaraj Pandian; Leonardo Pantoni; Nikolaos I.H. Papamitsakis; Adrian Parry-Jones; Thanh Phan; Gustavo Rodriguez; Jose G. Romano; Ziad Sabaa-Ayoun; Hamidreza Saber; Payam Sasannezhad; Jeffrey L. Saver; Eugene Scharf; Ashfaq Shuaib; Brian Silver; Shaloo Singhal; Craig J. Smith; Saverio Stranges; P. N. Sylaja; Michel Torbey; Kazunori Toyoda; Georgios Tsivgoulis; Mohammad Wasay; Nawaf Yassi; Takeshi Yoshimoto; Babak Zamani; Ramin Zand; Clinical Neurology Research Center; Beijing Tiantan Hospital, Capital Medical University; Luxembourg Institute of Health; The Aga Khan University; UNM School of Medicine; University of Alberta; University of California, San Diego; Robarts Research Institute; University of Miami; Eskişehir Osmangazi Üniversitesi; St. Louis University; Sree Chitra Tirunal Institute for Medical Sciences and Technology; University of Melbourne; Dresden University Faculty of Medicine and University Hospital Carl Gustav Carus; Universiti Putra Malaysia; Iran University of Medical Sciences; SUNY Downstate Health Sciences University; Manchester Metropolitan University; Cleveland Clinic Foundation; Kyorin University; Monash University; Singapore General Hospital; Institute for Clinical Evaluative Sciences; Foundation IRCCS Neurological Institute "C. Besta"; University of Toronto; Loyola University Health System; Kokuritsu Junkankibyo Senta; Dalhousie University; Attikon University Hospital; Inje University; Icahn School of Medicine at Mount Sinai; University of Zanjan; Faculty of Medicine, Siriraj Hospital, Mahidol University; Western University; Salford Royal NHS FoundationTrust; Geisinger Health System; China Medical University Taichung; Christian Medical College & Hospital, Ludhiana; Mayo Clinic; David Geffen School of Medicine at UCLA; The Mount Sinai Hospital; The University of Manchester; Mayo Clinic in Jacksonville, Florida; Ospedale Luigi Sacco - Polo Universitario; University of Tennessee Health Science Center; Mashhad University of Medical Sciences; University of Massachusetts Medical School; Chief of Cardiology; UTHealth McGovern Medical School; SMDN-Centre for Cardiovascular Medicine and Cerebrovascular Disease Prevention; Texas Tech Health University Health Sciences Center; Hospital Universitari Mútua Terrassa; San Camillo de' Lellis District General Hospital
    © 2020 Background and purpose: The novel severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), now named coronavirus disease 2019 (COVID-19), may change the risk of stroke through an enhanced systemic inflammatory response, hypercoagulable state, and endothelial damage in the cerebrovascular system. Moreover, due to the current pandemic, some countries have prioritized health resources towards COVID-19 management, making it more challenging to appropriately care for other potentially disabling and fatal diseases such as stroke. The aim of this study is to identify and describe changes in stroke epidemiological trends before, during, and after the COVID-19 pandemic. Methods: This is an international, multicenter, hospital-based study on stroke incidence and outcomes during the COVID-19 pandemic. We will describe patterns in stroke management, stroke hospitalization rate, and stroke severity, subtype (ischemic/hemorrhagic), and outcomes (including in-hospital mortality) in 2020 during COVID-19 pandemic, comparing them with the corresponding data from 2018 and 2019, and subsequently 2021. We will also use an interrupted time series (ITS) analysis to assess the change in stroke hospitalization rates before, during, and after COVID-19, in each participating center. Conclusion: The proposed study will potentially enable us to better understand the changes in stroke care protocols, differential hospitalization rate, and severity of stroke, as it pertains to the COVID-19 pandemic. Ultimately, this will help guide clinical-based policies surrounding COVID-19 and other similar global pandemics to ensure that management of cerebrovascular comorbidity is appropriately prioritized during the global crisis. It will also guide public health guidelines for at-risk populations to reduce risks of complications from such comorbidities.
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    Stroke Care Trends During COVID-19 Pandemic in Zanjan Province, Iran. From the CASCADE Initiative: Statistical Analysis Plan and Preliminary Results
    (2020-12-01) Abdoreza Ghoreishi; Shahram Arsang-Jang; Ziad Sabaa-Ayoun; Nawaf Yassi; P. N. Sylaja; Yama Akbari; Afshin A. Divani; Jose Biller; Thanh Phan; Sandy Steinwender; Brian Silver; Ramin Zand; Hamidon Bin Basri; Omer M. Iqbal; Annemarei Ranta; Sean Ruland; Elizabeth Macri; Henry Ma; Thanh N. Nguyen; Shahram Abootalebi; Animesh Gupta; Matias Alet; Simona Lattanzi; Masoom Desai; Rubens J. Gagliardi; Tarun Girotra; Manabu Inoue; Takeshi Yoshimoto; Cristian Flavo Isaac; Stephan A. Mayer; Negar Morovatdar; Yongchai Nilanont; Christa O.Hana S. Nobleza; Hamidreza Saber; Saltanat Kamenova; Aida Kondybayeva; Jerzy Krupinski; James E. Siegler; Saverio Stranges; Michel T. Torbey; Diana Yorio; María Cristina Zurrú; Clio Aracelli Rubinos; Reza Bavarsad Shahripour; Afshin Borhani-Haghighi; Mario Di Napoli; M. Reza Azarpazhooh; Vali-e-Asr Hospital, Zanjan University of Medical Sciences (ZUMS); Clinical Neurology Research Center; Department of Neurosciences; Kazakh National Medical University; Luxembourg Institute of Health; Al Farabi Kazakh National University; British Hospital Montevideo; UNM School of Medicine; Università Politecnica delle Marche; Robarts Research Institute; New York Medical College; University of Oklahoma Health Sciences Center; Loyola University Stritch School of Medicine; Walter and Eliza Hall Institute of Medical Research; Westchester Medical Center; Sree Chitra Tirunal Institute for Medical Sciences and Technology; University of Melbourne; Universiti Putra Malaysia; The University of North Carolina at Chapel Hill; Manchester Metropolitan University; Monash University; Cooper University Hospital; University of Otago; Kokuritsu Junkankibyo Senta; Dalhousie University; Faculty of Medicine, Siriraj Hospital, Mahidol University; Western University; UCI Beckman Laser Institute & Medical Clinic; Wayne State University; Instituto Universitario del Hospital Italiano de Buenos Aires; University of Mississippi Medical Center; Boston Medical Center; Geisinger Medical Center; Mashhad University of Medical Sciences; University of Massachusetts Medical School; School of Medicine, Zanjan University of Medical Sciences (ZUMS); Santa Casa of Sao Paulo Medical School; Hospital Dr. Arturo Oñativia; SMDN-Centre for Cardiovascular Medicine and Cerebrovascular Disease Prevention; Hospital Universitari Mútua Terrassa; San Camillo de' Lellis District General Hospital; Regional Stroke Prevention; Neurol. Div. Hospitals
    © 2020 Elsevier Inc. Background: The emergence of the COVID-19 pandemic has significantly impacted global healthcare systems and this may affect stroke care and outcomes. This study examines the changes in stroke epidemiology and care during the COVID-19 pandemic in Zanjan Province, Iran. Methods: This study is part of the CASCADE international initiative. From February 18, 2019, to July 18, 2020, we followed ischemic and hemorrhagic stroke hospitalization rates and outcomes in Valiasr Hospital, Zanjan, Iran. We used a Bayesian hierarchical model and an interrupted time series analysis (ITS) to identify changes in stroke hospitalization rate, baseline stroke severity [measured by the National Institutes of Health Stroke Scale (NIHSS)], disability [measured by the modified Rankin Scale (mRS)], presentation time (last seen normal to hospital presentation), thrombolytic therapy rate, median door-to-needle time, length of hospital stay, and in-hospital mortality. We compared in-hospital mortality between study periods using Cox-regression model. Results: During the study period, 1,026 stroke patients were hospitalized. Stroke hospitalization rates per 100,000 population decreased from 68.09 before the pandemic to 44.50 during the pandemic, with a significant decline in both Bayesian [Beta: -1.034; Standard Error (SE): 0.22, 95% CrI: -1.48, -0.59] and ITS analysis (estimate: -1.03, SE = 0.24, p < 0.0001). Furthermore, we observed lower admission rates for patients with mild (NIHSS < 5) ischemic stroke (p < 0.0001). Although, the presentation time and door-to-needle time did not change during the pandemic, a lower proportion of patients received thrombolysis (-10.1%; p = 0.004). We did not see significant changes in admission rate to the stroke unit and in-hospital mortality rate; however, disability at discharge increased (p < 0.0001). Conclusion: In Zanjan, Iran, the COVID-19 pandemic has significantly impacted stroke outcomes and altered the delivery of stroke care. Observed lower admission rates for milder stroke may possibly be due to fear of exposure related to COVID-19. The decrease in patients treated with thrombolysis and the increased disability at discharge may indicate changes in the delivery of stroke care and increased pressure on existing stroke acute and subacute services. The results of this research will contribute to a similar analysis of the larger CASCADE dataset in order to confirm findings at a global scale and improve measures to ensure the best quality of care for stroke patients during the COVID-19 pandemic.