MURCIA. Since the outbreak of covid-19 in the world in March 2000, there has been an increase in various pathologies. That is why its more in-depth study is required, to evaluate the possible influence of covid and/or its vaccines on its development.
One of the pathologies with the greatest clinical impact due to its repercussions at all levels (personal, family, social, professional, etc.) are cerebral stroke, possibly related to their potential hypercoagulable state in the acute phase of covid-19. However, it is not well established with sufficient evidence as a risk factor for them.
In a meta-analysis of 2,277 studies on stroke, 6 (2.7%) were selected for their homogeneity, which included 108,571 patients with covid. In this group, strokes were found in 1.4% and the most common clinical manifestation was the so-called ischemic stroke (cerebral thrombosis) in 787.4% and intracranial hemorrhage in 11.6%.
The covid group with cerebral stroke, with a significant difference from the non-covid group, was independently associated with older age (4.8 years older), along with the presence of hypertension, diabetes, coronary insufficiency or ischemic heart disease (angina pectoris-infarction acute myocardium) and covid with severe involvement.
Similarly, in another study with a registry of 23,559,428 patients with an average age of 56 years and 54.3% men, 1,595,984 patients with covid were evaluated with an average of 9.2 months of follow-up after overcoming it. Ischemic stroke was found in 4.4 per 1,000 patients who survived covid, compared to 3.25 per 1,000 of the control group without covid. That is, patients who recovered from Covid had a higher risk of ischemic or thromboembolic stroke compared to the general population group.
What are the main risk factors for stroke in covid?
Firstly, heart diseases, especially atrial fibrillation, as the most common cardiac arrhythmia in people >70 years of age, which favors cerebral thromboembolic episodes. Secondly, coronary insufficiency (angina-infarction), followed by diabetes and hypertension as is relatively common.
¿What influence do anti-covid vaccines have on the development of stroke?
In the follow-up controls of 395,105,670 patients vaccinated against Covid, no increase in strokes could be observed after carrying out the vaccination program up to 42 days of control.
There is only one study carried out at the CLINIC of Barcelona in a selected group of patients who suffered from temporal arteritis and were >70 years old. They found an increased risk of octus in this group in possible relation to the Anti-SAR-CoV RNA vaccines. Given these data, a larger study is needed and especially a personalized assessment of these agents in this group of patients.
As conclusions we can point out: covid increases the risk of stroke, mainly related to cardiogenic factors (atrial fibrillation and ischemic heart disease).
Vaccines have not been found to be a risk factor for stroke, except in a limited group of patients with Temporal Arteritis and over 70 years of age, considering the limitation of vaccination in this group of patients.
Joaquín Gómez Gómez
Emeritus Professor of Internal-Infectious Medicine at the University of Murcia.
2023-09-10 04:01:26
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