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A substudy of the 'Rates, Risks and Routes to Reduce Vascular Dementia' (R4VaD) project, aiming to evaluate the impact of the current COVID-19 pandemic on patients presenting with stroke to UK stroke centres.

R4VaD logo

Rates, Risks and Routes to Reduce Vascular Dementia (R4VaD) is an observational study of cognitive, physical and neuropsychiatric complications after stroke. We have recruited over 2000 participants with stroke from over 50 UK hospitals.

Reports from China suggest that patients with pre-existing comorbidities such as diabetes, hypertension and cerebrovascular disease may be among those at highest risk of acquiring COVID-19, and may have worse outcomes. Furthermore, COVID-19 may be a risk factor for ischaemic stroke and may influence its severity and prognosis. Therefore, following a pause in recruitment in 2020 due to restrictions, we incorporated a COVID-19 substudy into our study protocol.

We aim to:

  • To determine the prevalence of COVID-19 infection in patients admitted with acute stroke to UK stroke centres currently participating in R4VaD.
  • In patients with both acute stroke and COVID-19 infection, to explore the relationship between the onset times of the symptoms related to these two illnesses.
  • To compare the clinical and laboratory features, stroke mechanism and phenotypes of patients with acute stroke and acute COVID-19 infection to those of patients with acute stroke without COVID-19 infection, and between mild and severe COVID-19 disease.
  • To characterize clinical outcomes (recurrent stroke, functional outcome) in patients with acute stroke and COVID-19 infection compared to those without COVID-19 infection.
  • Examine the neuropsychological impact of the COVID-19 outbreak on patients with stroke.

Project team

R4VaD is a collaboration across several UK Universities, and the research is performed at over 50 UK hospitals.

The Chief Investigator is Professor Joanna Wardlaw

Our local team members include Dr Fergus Doubal (Principal investigator), Dr Ellen Backhouse, Dr Rosalind Brown (study management), Rachel Penman (research assistant), Allan MacRaild, Michelle Coakley, Seona Burgess, Jessica Teasdale (research nurses), Eleni Sakka (imaging management) and the radiography team

Project title and funder

Rates, Risks and Routes to Reduce Vascular Dementia (R4VaD) is funded by the Stroke Association, Alzheimer's Society, British Heart Foundation, Dementias Platform UK and the British Heart Foundation Centre for Research Excellence in Edinburgh.

Related links

R4VaD study website

R4VaD protocol paper: Wardlaw et al, Rates, risks and routes to reduce vascular dementia (R4vad), a UK-wide multicentre prospective observational cohort study of cognition after stroke: Protocol, European Stroke Journal 2020. DOI:10.1177/2396987320953312

Study information on The Stroke Association website