Impact of COVID-19 on emergency department management of stroke and STEMI. A narrative review

Am J Emerg Med. 2022 Jul:57:91-97. doi: 10.1016/j.ajem.2022.04.033. Epub 2022 May 1.


The novel coronavirus of 2019 (COVID-19) has resulted in a global pandemic; COVID-19 has resulted in significant challenges in the delivery of healthcare, including emergency management of multiple diagnoses, such as stroke and ST-segment myocardial infarction (STEMI). The aim of this study was to identify the impacts of the COVID-19 pandemic on emergency department care of stroke and STEMI patients. In this study a review of the available literature was performed using pre-defined search terms, inclusion criteria, and exclusion criteria. Our analysis, using a narrative review format, indicates that there was not a significant change in time required for key interventions for stroke and STEMI emergent management, including imaging (door-to-CT), tPA administration (door-to-needle), angiographic reperfusion (door-to-puncture), and percutaneous coronary intervention (door-to-balloon). Potential future areas of investigation include how emergency department (ED) stroke and STEMI care has adapted in response to different COVID-19 variants and stages of the pandemic, as well as identifying strategies used by EDs that were successful in providing effective emergency care in the face of the pandemic.

Keywords: CVA; Covid-19 pandemic; Emergency department; ST-segment elevation myocardial infarction; STEMI; Stroke.

Publication types

  • Review

MeSH terms

  • COVID-19* / therapy
  • Emergency Service, Hospital
  • Humans
  • Myocardial Infarction* / diagnosis
  • Pandemics
  • Percutaneous Coronary Intervention*
  • SARS-CoV-2
  • ST Elevation Myocardial Infarction* / diagnosis
  • ST Elevation Myocardial Infarction* / epidemiology
  • ST Elevation Myocardial Infarction* / therapy
  • Stroke* / diagnosis
  • Stroke* / therapy

Supplementary concepts

  • SARS-CoV-2 variants