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“Doctors and practitioners who treat patients with Covid-19 infection must remain alert to the signs and symptoms of stroke, because a rapid diagnosis can enable effective stroke treatment,” said Dr. Neal Parikh, who is an assistant professor of neurology and neuroscience at Weill Cornell Medical, New York, United States.
“Basically, our results support the idea that Covid-19 infection is more severe than influenza infection,” Parikh added. Web MD.
For this study, Parikh and colleagues compared the incidence of stroke between Covid-19 patients and flu patients in two New York City hospitals. Patients with Covid-19 were assessed March 4 to May 2, while researchers analyzed flu data from January 1, 2016 to May 31, 2018.
Two neurologists who reviewed the findings were not surprised that Covid-19 was associated with stroke. “Infection and other inflammatory conditions are risk factors for stroke, so it is not surprising that patients with Covid-19 disease may experience a stroke as a complication of infection,” explained Dr. Larry Goldstein, Chair of the Department of Neurology and Co-Director of the Kentucky Neuroscience Institute.
Covid-19 disease is also associated with blood clots which can increase the risk of stroke. “This virus has a tendency to cause some degree of clotting, and we think maybe it is due to an increase in inflammation in the body,” said Salman Azhar of Lenox Hill Hospital, New York City.
Azhar added that Covid-19 attacks cells lining blood vessels, which is one of the reasons for the increased risk of blood clots that cause strokes. “Also, the virus increases the production of clotting factors,” he said.
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Antibodies also play a role in the development of stroke. “There are antibodies that we have known for a long time, they have nothing to do with this virus, but we know they increase the risk of people having strokes and other blood vessel clots, and we see them in a higher incidence in patients with Covid-19,” explained Azhar
Because of this risk, Covid-19 patients are monitored for signs of clotting. In general, every patient with Covid-19 will use a low level of blood thinner to try and prevent clotting.
Patients who experience blood clots use blood thinners at higher doses so that they do not experience blood clots that can damage vital organs. According to Azhar, both young and old Covid-19 patients can experience freezing, with the most severe risk.
In some patients, stroke may be the first sign of Covid-19. In this study, more than a quarter of patients went to the emergency room for a stroke and were later diagnosed with Covid-19.
Fortunately, only a small proportion of Covid-19 patients have a stroke. Of the 1,916 patients who had the virus in this study, 31 suffered a stroke. However, disability after a stroke can be a long-lasting effect of the virus.
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“However, Covid-19’s disease is clearly linked to the tendency to form blood clots, and stroke needs to be considered as a possible complication,” Goldstein said.
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