The Impact of Covid-19 and Vaccination on Stroke Cases: Expert Insights

1. Today, October 29, is World Stroke Day. Why are cases increasing?

Dr. Rafael Arroyo (RA): Stroke is a very common pathology, whose incidence is related to very common cerebrovascular risk factors, such as blood pressure, diabetes, tobacco and cholesterol. Your risk increases exponentially with age. The increase in these risk factors and an increasingly aging population perfectly explain the increase in stroke cases in our environment.

2. In addition to the older population, sedentary lifestyle, eating poorly, etc., how does Covid-19 affect us? And does having gone through it affect you?

Dr. Jaime González-Valcárcel (JG) A slight increase in the risk of stroke has been seen in patients with Covid-19, especially in patients with severe infections that require admission to the ICU. In mild cases, the risk is very low, less than 1%. This small increase in risk has been seen mainly in the acute phase, in the first three weeks after infection.

3. Once again, the rumor is circulating that the covid and flu vaccines could be behind the increase in stroke cases. Why, in general, do adverse reactions to vaccines not increase stroke cases in the elderly or young?

JG: The AstraZeneca vaccine was associated with a minimal risk of a rare type of stroke such as cerebral venous thrombosis, at less than one in 100,000 after the first dose, and even lower with successive doses. The rest of the vaccines have not been related to brain or cardiovascular events, so they should not worry us from this point of view, nor the current vaccines for covid or flu, so when faced with a clearly established indication, people have to vaccinate without fear.

4. If an older person asked you this question, what would you answer to encourage them to get vaccinated?

RA: Vaccines are indicated in high-risk patients to prevent serious symptoms due to covid, and they are safe from a cerebrovascular point of view, so I would encourage them to follow current recommendations and get vaccinated.

5. By what percentage does the flu increase the risk of stroke? And the covid?

JG: Although the relationship between the flu and the risk of stroke has always been discussed, a recent study showed that flu vaccination reduced the risk of having a stroke between 22 and 25%, with this reduction being more significant in patients high-risk. In the case of covid, the risk of having a stroke is also very low, and depends on the severity of the infection. In mild cases, it is less than 1%, and in severe cases with ICU admissions it can increase to 2-3%.

6. The Ruber Juan Bravo University Hospital has launched a clinical research unit. One of its trials is to prevent recurrences. How many participants do you have? Objective of the essay?

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RA: Although in recent decades therapeutic advances allow us to protect our patients very well, we always want to do better, and reduce the risk of having a stroke to the minimum possible. In this context, we are participating in several international clinical trials in which high-level stroke care centers in Spain and around the world include high-risk patients to find new preventive stroke treatments.

7. How many people suffer a stroke and how many recurrences?

RA: The annual incidence of stroke in Spain is between 100,000 and 120,000 new cases each year, and the risk of recurrence is estimated at 30% five years after the first episode.

8. Stroke cases will skyrocket by 35% in 2035, what symptoms to notice and what to do?

JG: It is essential to recognize the symptoms of a stroke to immediately go to a center with a stroke unit to receive appropriate treatment. If there is a sudden onset of difficulty speaking, loss of vision, strength or sensitivity on one side of the body, a stroke should be suspected and emergency services should be called.

9. After a stroke, do all patients need rehabilitation? In which cases yes and for how long?

RA: Rehabilitation after a stroke is very important, especially for patients who have sequelae after the acute phase. These consequences can be due to loss of strength, balance problems, language or eating disorders. All of these sequelae benefit from rehabilitative treatment. Its duration will depend on the severity and clinical evolution of the patient, and in some cases they may benefit from this type of treatment up to six to 12 months after the stroke.

10. Strokes are the leading cause of hospital admissions in our country. How many people with stroke die? How many are left with serious consequences? And how many recover 100% and are able to drive again, for example?

JG: Strokes are the first cause of death in women and the second overall in our environment. Stroke mortality is between 7 and 15% depending on the type and severity. Thanks to advances in management during the acute phase, more and more patients have a favorable recovery after a stroke. However, stroke continues to be the main cause of disability in adults, since around 30% of those who suffer a serious stroke may be left with significant sequelae.

2023-10-29 00:04:01
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