AHA/ASA Guidance on the Role of Stroke Centers During the Pandemic

Stroke centers have procedural and multidisciplinary clinical expertise to adequately support COVID-19 treatment teams.

Stroke centers have procedural and multidisciplinary clinical expertise to adequately support coronavirus disease 2019 (COVID-19) treatment teams, yet many stroke centers lack guidance on how they can assist staffing challenges during the pandemic, according to a guidance statement published in Stroke.

The guidance statement was published on behalf of the Stroke Nursing Science Subcommittee of the American Heart Association (AHA)/American Stroke Association (ASA) Cardiovascular and Stroke Nursing Council as well as the AHA/ASA Stroke Council Science Subcommittees, including the Emergency Neurovascular Care, Telestroke, and the Neurovascular Intervention Committees.

Statement authors suggest that stroke centers, with their multidisciplinary teams, may wish to lend some of their staff members to other units to manage patients with COVID-19, especially during rapidly increases in COVID-19 cases.

Local nurse leadership at stroke units may also reassign nurses to support COVID-19 treatment teams in the emergency room, on the floor, or in the intensive care unit (ICU).

Neuro-intensivists, neuro-hospitalists, and stroke/vascular neurologists may also be invited by hospital leadership from stroke centers to manage internal medicine COVID-19 treatment teams that support noncritically ill patients with the disease. Smaller stroke centers that have a limited number of staff and beds, however, may find reassignment of staff more problematic.

The authors also recommend that neuro-hospitalist leaders, stroke center medical directors, and neonatal ICU leaders remain in close communication to discuss optimal procedures and protocols adjusted to hospital capacity. They also need to identify how a stroke center may reduce its use of ICU beds if a center becomes overwhelmed during the pandemic. In some cases, beds within stroke centers may be converted into COVID-19 units or overflow beds, if needed.

 “[T]here needs to be continuing focus on staff wellness and team performance such that stroke providers can rise to this challenge with our other colleagues to provide excellent stroke-specific care and assistance to other specialized areas,” noted the statement authors.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Wira CR, Goyal M, Southerland AM, et al. Pandemic guidance for stroke centers aiding COVID-19 treatment teams [published online June 23, 2020]. Stroke. doi: 10.1161/STROKEAHA.120.030749