Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, et al. Heart disease and stroke statistics—2018 update: a report from the American Heart Association. Circulation. 2018;137:E67–492.

PubMed  Article  Google Scholar 

Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2095–128.

PubMed  Article  Google Scholar 

The NINDS rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995;333:1581–7.

Article  Google Scholar 

• Lin Y, Schulze V, Brockmeyer M, Parco C, Karathanos A, Heinen Y, et al. Endovascular thrombectomy as a means to improve survival in acute ischemic stroke. JAMA Neurol. 2019;850. https://doi.org/10.1001/jamaneurol.2019.0525. Metanalysis showing the significance of endovascular thrombectomy in improving the outcomes of patients withs stroke.

Lecouturier J, Rodgers H, Murtagh MJ, White M, Ford GA, Thomson RG. Systematic review of mass media interventions designed to improve public recognition of stroke symptoms, emergency response and early treatment. BMC Public Health. 2010;10:784.

PubMed  PubMed Central  Article  Google Scholar 

Musuka TD, Wilton SB, Traboulsi M, Hill MD. Diagnosis and management of acute ischemic stroke: speed is critical. CMAJ. 2015;187:887–93.

PubMed  PubMed Central  Article  Google Scholar 

Tan J, Ramazanu S, Liaw SY, Chua WL. Effectiveness of public education campaigns for stroke symptom recognition and response in non-elderly adults: a systematic review and meta-analysis. J Stroke Cerebrovasc Dis. 2022;31:106207.

PubMed  Article  Google Scholar 

Adeoye O, Nyström KV, Yavagal DR, Luciano J, Nogueira RG, Zorowitz RD, et al. Recommendations for the establishment of stroke systems of care: a 2019 update. Stroke. 2019. https://doi.org/10.1161/str.0000000000000173.

Article  PubMed  Google Scholar 

Schwamm LH, Ali SF, Reeves MJ, Smith EE, Saver JL, Messe S, et al. Temporal trends in patient characteristics and treatment with intravenous thrombolysis among acute ischemic stroke patients at get with the guidelines-stroke hospitals. Circ Cardiovasc Qual Outcomes. 2013;6:543–9.

PubMed  Article  Google Scholar 

• Hammond G, Luke AA, Elson L, Towfighi A, Joynt Maddox KE. Urban-rural inequities in acute stroke care and in-hospital mortality. Stroke. 2020;51:2131–8. Cohort study using National Inpatient Sample data highlighting healthcare inequities between urban and rural areas.

PubMed  Article  Google Scholar 

Board on Health Care Services, Institute of Medicine. The role of telehealth in an evolving health care environment: workshop summary. National Academies Press; 2012.

Levine SR, Gorman M. “Telestroke” : the application of telemedicine for stroke. Stroke. 1999;30:464–9.

CAS  PubMed  Article  Google Scholar 

Nguyen-Huynh MN, Klingman JG, Avins AL, Rao VA, Eaton A, Bhopale S, et al. Novel telestroke program improves thrombolysis for acute stroke across 21 hospitals of an integrated healthcare system. Stroke. 2018;49:133–9.

PubMed  Article  Google Scholar 

• Lyerly MJ, Daggy J, LaPradd M, Martin H, Edwards B, Graham G, et al. Impact of telestroke implementation on emergency department transfer rate. Neurology. 2022;98:e1617–25. Retrospective study showing the impact of telestroke in optimizing disposition and avoiding inter-institutional transfers.

PubMed  Article  Google Scholar 

Richard JV, Wilcock AD, Schwamm LH, Uscher-Pines L, Zachrison KS, Siddiqui A, et al. Assessment of telestroke capacity in US hospitals. JAMA Neurol. 2020;77:1035–7.

PubMed  PubMed Central  Article  Google Scholar 

Haleem A, Javaid M, Vaishya R. Effects of COVID-19 pandemic in daily life. Curr Med Res Pract. 2020;10:78–9.

PubMed  PubMed Central  Article  Google Scholar 

Suran M. Increased use of medicare telehealth during the pandemic. JAMA. 2022;327:313.

PubMed  Google Scholar 

AHA/ASA Stroke Council Leadership. Temporary emergency guidance to US stroke centers during the coronavirus disease 2019 (COVID-19) pandemic: on behalf of the American heart association/American stroke association stroke council leadership. Stroke. 2020;51:1910–2.

Article  CAS  Google Scholar 

• Siegler JE, Heslin ME, Thau L, Smith A, Jovin TG. Falling stroke rates during COVID-19 pandemic at a comprehensive stroke center. J Stroke Cerebrovasc Dis. 2020;29:104953. Single center study showing decrease in the stroke rates during the early COVID-19 pandemic.

CAS  PubMed  PubMed Central  Article  Google Scholar 

Uchino K, Kolikonda MK, Brown D, Kovi S, Collins D, Khawaja Z, et al. Decline in stroke presentations during COVID-19 surge. Stroke. 2020;51:2544–7.

CAS  PubMed  Article  Google Scholar 

Kerleroux B, Fabacher T, Bricout N, Moise M, Testud B, Vingadassalom S, et al. Mechanical thrombectomy for acute ischemic stroke amid the COVID-19 outbreak in France: decreased activity, and increased care delays. SSRN Electron J. https://doi.org/10.2139/ssrn.3571545.

Qureshi AI, Siddiq F, French BR, Gomez CR, Jani V, Hassan AE, et al. Effect of COVID-19 pandemic on mechanical thrombectomy for acute ischemic stroke treatment in United States. J Stroke Cerebrovasc Dis. 2020;29:105140.

PubMed  PubMed Central  Article  Google Scholar 

Nogueira RG, Davies JM, Gupta R, Hassan AE, Devlin T, Haussen DC, et al. Epidemiological surveillance of the impact of the COVID-19 pandemic on stroke care using artificial intelligence. Stroke. 2021;52:1682–90.

CAS  PubMed  PubMed Central  Article  Google Scholar 

• Huang JF, Greenway MRF, Nasr DM, Chukwudelunzu FE Sr, Demaerschalk BM, O’Carroll CB, et al. Telestroke in the time of COVID-19: the Mayo Clinic experience. Mayo Clin Proc. 2020;95:1704–8. Single center study showing decrease in their telestroke code activations during the early COVID-19 pandemic.

CAS  PubMed  Article  Google Scholar 

Elkind MSV, Boehme AK, Smith CJ, Meisel A, Buckwalter MS. Infection as a stroke risk factor and determinant of outcome after stroke. Stroke. 2020;51:3156–68.

CAS  PubMed  PubMed Central  Article  Google Scholar 

Stamm P, Sagoschen I, Weise K, Plachter B, Münzel T, Gori T, et al. Influenza and RSV incidence during COVID-19 pandemic—an observational study from in-hospital point-of-care testing. Med Microbiol Immunol. 2021;210:277–82.

CAS  PubMed  PubMed Central  Article  Google Scholar 

Velez FGS, Saleh Velez FG, Alvarado-Dyer R, Del Brutto VJ, Carrión-Penagos J, Bulwa Z, et al. Impact of COVID-19 on stroke code activations, process metrics, and diagnostic error. The Neurohospitalist. 2021;197–203. https://doi.org/10.1177/1941874420976517.

• Guzik AK, Martin-Schild S, Tadi P, Chapman SN, Al Kasab S, Martini SR, et al. Telestroke across the continuum of care: lessons from the COVID-19 pandemic. J Stroke Cerebrovasc Dis. 2021;30:105802. Comprehensive review highlighting the potential roles of telestroke across stroke care continuum during the COVID-19 pandemic.

PubMed  Article  Google Scholar 

Hale TM, Kvedar JC. Privacy and security concerns in telehealth. Virtual Mentor. 2014;16:981–5.

PubMed  Google Scholar 

Severino, Director. Notification of enforcement discretion for telehealth remote communications during the COVID-19 nationwide public health emergency. US Department of Health & Human. Available: https://upweegrow.com/images/3172020_-_HIPPA_Laws_Relaxed_-_Notification_of_Enforcement_Discretion_for_telehealth_remote_communications_during_the_COVID-19_nationwide_public_health_emergency.pdf.

Demaerschalk BM, Berg J, Chong BW, Gross H, Nystrom K, Adeoye O, et al. American Telemedicine Association: telestroke guidelines. Telemed J E Health. 2017;23:376–89.

PubMed  PubMed Central  Article  Google Scholar 

Federation of State Medical Boards. US States and Territories modifying requirements for telehealth in response to COVID-19. DC: Federation of State Medical Boards Washington; 2020.

Google Scholar 

• Wilcock AD, Schwamm LH, Zubizarreta JR, Zachrison KS, Uscher-Pines L, Majersik JJ, et al. Legislation increased Medicare telestroke billing, but underbilling and erroneous billing remain common. Health Aff. 2022;41:350–9. Comprehensive review showing increased reimbursement for telestroke services by Medicare.

Article  Google Scholar 

Verma S. Early Impact Of CMS Expansion of Medicare telehealth during COVID-19. [cited 11 Jun 2022]. https://doi.org/10.1377/forefront.20200715.454789.

Khosravani H, Rajendram P, Notario L, Chapman MG, Menon BK. Protected code stroke: hyperacute stroke management during the coronavirus disease 2019 (COVID-19) pandemic. Stroke. 2020;51:1891–5.

CAS  PubMed  PubMed Central  Article  Google Scholar 

Meyer D, Meyer BC, Rapp KS, Modir R, Agrawal K, Hailey L, et al. A stroke care model at an academic, comprehensive stroke center during the 2020 COVID-19 pandemic. J Stroke Cerebrovasc Dis. 2020;29:104927.

PubMed  PubMed Central  Article  Google Scholar 

Al Kasab S, Almallouhi E, Holmstedt CA. Optimizing the use of teleneurology during the COVID-19 pandemic. Telemedicine and e-Health. 2020;26:1197–8.

CAS  PubMed  Article  Google Scholar 

Kolikonda MK, Blaginykh E, Brown P, Kovi S, Zhang LQ, Uchino K. Virtual rounding in stroke care and neurology education during the COVID-19 pandemic - a residency program survey. J Stroke Cerebrovasc Dis. 2022;31:106177.

PubMed  Article  Google Scholar 

• Al Kasab S, Almallouhi E, Debenham E, Turner N, Simpson KN, Holmstedt CA. Beyond acute stroke: rate of stroke transfers to a tertiary centre following the implementation of a dedicated inpatient teleneurology network. J Telemed Telecare. 2021;27: 239–43. Study showing the role of new inpatient teleneurology networks in managing stroke patients remotely and minimizing overall healthcare costs.

Sobhani F, Desai S, Madill E, Starr M, Rocha M, Molyneaux B, et al. Remote longitudinal inpatient acute stroke care via telestroke. J Stroke Cerebrovasc Dis. 2021;30:105749.

PubMed  Article  Google Scholar 

Woolf C, Caute A, Haigh Z, Galliers J, Wilson S, Kessie A, et al. A comparison of remote therapy, face to face therapy and an attention control intervention for people with aphasia: a quasi-randomised controlled feasibility study. Clin Rehabil. 2016;30:359–73.

PubMed  Article  Google Scholar 

Sarfo FS, Ulasavets U, Opare-Sem OK, Ovbiagele B. Tele-rehabilitation after stroke: an updated systematic review of the literature. J Stroke Cerebrovasc Dis. 2018;27:2306–18.

PubMed  PubMed Central  Article  Google Scholar 

• Cramer SC, Dodakian L, Le V, See J, Augsburger R, McKenzie A, et al. Efficacy of home-based telerehabilitation vs in-clinic therapy for adults after stroke: a randomized clinical trial. JAMA Neurol. 2019;76: 1079–87. Clinical trial highlighting the effectiveness of tele-rehabilitation compared to office-based therapy in patients with ischemic stroke.

Llorens R, Noe E, Colomer C. Effectiveness, usability, and cost-benefit of a virtual reality-based telerehabilitation program for balance recovery after stroke: a randomized controlled trial. of physical medicine …. Available: https://riunet.upv.es/handle/10251/63762.

Harrison SL, Fazio-Eynullayeva E, Lane DA, Underhill P, Lip GYH. Higher mortality of ischaemic stroke patients hospitalized with COVID-19 compared to historical controls. Cerebrovasc Dis. 2021;50:326–31.

CAS  PubMed  Article  Google Scholar 

Chun H-YY, Ford A, Kutlubaev MA, Almeida OP, Mead GE. Depression, anxiety, and suicide after stroke: a narrative review of the best available evidence. Stroke. 2022;53:1402–10.

PubMed  Article  Google Scholar 

Yao M, Li H, Luo Y, Li L, Yu J. High prevalence of post-stroke anxiety in elderly patients following COVID-19 outbreak. Front Psychiatry. 2021;12:699869.