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| Ischemic Stroke - Credit Wikipedia |
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As I mentioned earlier today, we continue to see new reports of long-term sequelae resulting from severe COVID-19 disease, including damage to the lungs, heart, and other organs. While most people appear to recover fully after a mild or moderate illness, for a minority of survivors, it can be a long road back to health.
- Last April, in Large-Vessel Stroke as a Presenting Feature of Covid-19 in the Young), we looked at 5 cases of large-vessel stroke in patients < 50 years of age who were diagnosed with COVID-19 in New York City.
- More recently, in The Lancet: Yet Another Study On Neurological Manifestations In Severe COVID-19 Patients, we looked at high rate of neurological involvement - some permanent - among hospitalized COVID cases.
Today, we've a new study, published yesterday in JAMA, that finds the risk of ischemic stroke elevated with COVID-19 compared to influenza. While they found the risk of stroke was low (1.6%) with COVID, it was 7-times higher than a similar cohort with influenza (.2%).
You can follow the link below to read the study in its entirety. I'll have more after you return.
Although influenza infection has been linked to increased rates of heart attack (see Int. Med. J.: Triggering Of Acute M.I. By Respiratory Infection ) and stroke (see Neuroinfluenza: A Review Of Recently Published Studies), the reports we've seen with COVID-19 have been far more pronounced.
Three months ago, in JAMA: Neurologic Manifestations Of Patients With Severe Coronavirus Disease, we looked at reports that more than 1/3rd of a study group of 214 patients hospitalized with COVID-19 in Wuhan, China showed signs of neurological involvement.Of note, in this study neurological symptoms were detected in 30.2% of non-severe cases, and nearly half (45.5%) of severe cases. While most of these manifestations were temporary, some were persisted post-recovery, and some resulted in death.
Neurological manifestations ranged from relatively mild (headaches, dizziness, anosmia, mild confusion, etc.) to more profound (seizures, stupor, loss of consciousness, etc.) to potentially fatal (ischemic stroke, cerebral hemorrhage, muscle injury (rhabdomyolysis), etc.).
We've seen numerous reports of thrombotic events (blood clots) associated with COVID-19 (see EID Journal: Two Reports On Thrombotic Events In COVID-19 Patients and EID Journal: Pulmonary Embolism and Increased Levels of d-Dimer in COVID-19 Patients), which makes the increased risk of ischemic stroke somewhat less surprising.
COVID-19, while originally viewed as a respiratory disease, continues to demonstrate its ability to impact patients in a variety of unexpected ways.
For some past blogs on some of the other unusual aspects of COVID-19, you may wish to revisit:
